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Dekker T, Hefele L, Neven A, Hübschen JM, Essink DR, Black AP. Factors associated with hepatitis B vaccination in Laos: findings from the multiple indicator cluster surveys in 2011/12 and 2017. Lancet Reg Health West Pac 2024; 46:101059. [PMID: 38645739 PMCID: PMC11033145 DOI: 10.1016/j.lanwpc.2024.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024]
Abstract
Background Within Laos, the vaccination coverage rates with the monovalent hepatitis B birth dose vaccine and hepatitis B antigen-containing combination vaccines remain stagnant with 75% and 64%, respectively, in 2021. In this study, we used data from the Multiple Indicator Cluster Surveys to identify possible factors that represent barriers for receiving these childhood vaccinations. Methods Data from the Multiple Indicator Cluster Surveys in 2011/12 and 2017 were analysed to examine factors associated with receiving the hepatitis B-containing vaccines using regression modelling. Data analyses were conducted in R. Findings In 2011/12, the weight-adjusted coverage rate for receiving the hepatitis B birth dose was 48%, while the coverage with the hepatitis B antigen-containing combination vaccine was 55.1% based on both vaccination documents and recall; compared to 69.3% and 59.4% respectively in 2017. Ethno-linguistic group, maternal education, healthcare utilization and wealth were associated with receiving the vaccinations against hepatitis B. Interpretation National estimates of vaccination coverage rates can conceal country-specific regional or socio-economic variations. Children from Hmong-Mien households, from less wealthier households and whose mothers were less educated and were not able to or did not utilize healthcare were identified as being less likely to receive the vaccinations. These findings indicate the need for improving access to healthcare, in particular for minority groups. Funding This work was supported by the Ministry of Foreign and European Affairs, Luxembourg and the Luxembourg Institute of Health (project "Luxembourg-Laos Partnership for Research and Capacity Building in Infectious Disease Surveillance").
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Affiliation(s)
- Trude Dekker
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands
| | - Lisa Hefele
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Anouk Neven
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Judith M. Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Dirk R. Essink
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands
| | - Antony P. Black
- LaoLuxLab, Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic
- School of Life Sciences, University of Westminster, London, UK
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Iacob S, Gheorghe L, Onica M, Huiban L, Pop CS, Brisc C, Sirli R, Ester C, Brisc CM, Diaconu S, Rogoveanu I, Sandulescu L, Vuletici D, Trifan A. Prospective study of hepatitis B and D epidemiology and risk factors in Romania: A 10-year update. World J Hepatol 2024; 16:640-649. [DOI: 10.4254/wjh.v16.i4.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/19/2024] [Accepted: 03/22/2024] [Indexed: 04/24/2024] Open
Abstract
BACKGROUND The global burden of hepatitis D virus (HDV) infection represents a major medical challenge and a public health crisis worldwide. However, there is a lack of accurate data on the epidemiology and risk factors for HDV. Hepatitis B virus (HBV) and HDV coinfection causes the most severe form of viral hepatitis, leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection, including the need for liver transplantation and death.
AIM To investigate the epidemiology, natural history, risk factors and clinical management of HBV and HDV coinfection in Romanian patients.
METHODS This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in Romania. All consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were enrolled. Patients with acute hepatitis or incomplete data were excluded. Of the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period, 963 met the inclusion criteria. Testing for anti-HDV antibodies and HDV RNA was performed for all participants. Demographic and risk factor data were collected by investigators using medical charts and patient questionnaires. All data were stored in an anonymized online database during the study.
RESULTS The prevalence of HBV was 3.8%; among these patients, the prevalence of HBV/HDV coinfection was 33.1%. The median age of the study population was 54.0 years, and it consisted of 55.1% men. A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years old. Patients with HBV/HDV coinfection were significantly older than those with HBV monoinfection (P = 0.03). Multivariate multiple regression analysis identified female gender (P = 0.0006), imprisonment (P < 0.0001), older age at diagnosis (P = 0.01) and sexual contact with persons with known viral hepatitis (P = 0.0003) as significant risk factors for HDV.
CONCLUSION This study shows that HDV infection among those with HBV remains endemic in Romania and updates our understanding of HDV epidemiology and associated risk factors. It emphasizes the need for systematic screening for HDV infection and collaborative initiatives for controlling and preventing HBV and HDV infection.
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Affiliation(s)
- Speranta Iacob
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest 022328, Romania
| | - Liana Gheorghe
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest 022328, Romania
| | - Mirela Onica
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest 022328, Romania
| | - Laura Huiban
- Department of Gastroenterology, Grigore T Popa University of Medicine and Pharmacy, Iasi 700115, Romania
- Institute of Gastroenterology and Hepatology, Saint Spiridon County Hospital, Iasi 700111, Romania
| | - Corina Silvia Pop
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Gastroenterology and Medical Oncology, University Emergency Clinical Hospital, Bucharest 050098, Romania
| | - Ciprian Brisc
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410087, Romania
- Department of Gastroenterology, Emergency County Hospital, Oradea 410169, Romania
| | - Roxana Sirli
- Center for Advanced Research in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, Timisoara 300041, Romania
- Department of Gastroenterology and Hepatology, Timiş County Emergency Clinical Hospital "Pius Branzeu", Timisoara 300723, Romania
| | - Carmen Ester
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest 022328, Romania
| | - Cristina Mihaela Brisc
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410087, Romania
- Department of Gastroenterology, Emergency County Hospital, Oradea 410169, Romania
| | - Sorina Diaconu
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Internal Medicine II and Gastroenterology, University Emergency Clinical Hospital, Bucharest 050098, Romania
| | - Ion Rogoveanu
- Department of Gastroenterology, University of Medicine and Pharmacy, Craiova 200349, Romania
- Department of Cardiology, Emergency County Hospital, Craiova 200642, Romania
| | - Larisa Sandulescu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova 200349, Romania
- Department of Gastroenterology, Emergency County Hospital, Craiova 200642, Romania
| | - Deiana Vuletici
- Center for Advanced Research in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, Timisoara 300041, Romania
- Department of Gastroenterology and Hepatology, Timiş County Emergency Clinical Hospital "Pius Branzeu", Timisoara 300723, Romania
| | - Anca Trifan
- Institute of Gastroenterology and Hepatology, Saint Spiridon County Hospital, Iasi 700111, Romania
- Department of Gastroenterology, Faculty of Medicine, Grigore T Popa University of Medicine and Pharmacy, Iasi 700115, Romania
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Lee DU, Bhowmick K, Kolachana S, Schuster K, Bahadur A, Harmacinski A, Schellhammer S, Fan GH, Lee KJ, Sun C, Chou H, Lominadze Z. Inpatient Cost Burdens of Treating Chronic Hepatitis B in US Hospitals: A Weighted Analysis of a National Database. Dig Dis Sci 2024:10.1007/s10620-024-08448-z. [PMID: 38658506 DOI: 10.1007/s10620-024-08448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS This study evaluates the cost burdens of inpatient care for chronic hepatitis B (CHB). We aimed to stratify the patients based on the presence of cirrhosis and conduct subgroup analyses on patient demographics and medical characteristics. METHODS The 2016-2019 National Inpatient Sample was used to select individuals diagnosed with CHB. The weighted charge estimates were derived and converted to admission costs, adjusting for inflation to the year 2016, and presented in United States Dollars. These adjusted values were stratified using select patient variables. To assess the goodness-of-fit for each trend, we graphed the data across the respective years, expressed in a chronological sequence with format (R2, p-value). Analysis of CHB patients was carried out in three groups: the composite CHB population, the subset of patients with cirrhosis, and the subset of patients without cirrhosis. RESULTS From 2016 to 2019, the total costs of hospitalizations in CHB patients were $603.82, $737.92, $758.29, and $809.01 million dollars from 2016 to 2019, respectively. We did not observe significant cost trends in the composite CHB population or in the cirrhosis and non-cirrhosis cohorts. However, we did find rising costs associated with age older than 65 (0.97, 0.02), white race (0.98, 0.01), Hispanic ethnicity (1.00, 0.001), and Medicare coverage (0.95, 0.02), the significance of which persisted regardless of the presence of cirrhosis. Additionally, inpatients without cirrhosis who had comorbid metabolic dysfunction-associated steatotic liver disease (MASLD) were also observed to have rising costs (0.96, 0.02). CONCLUSIONS We did not find a significant increase in overall costs with CHB inpatients, regardless of the presence of cirrhosis. However, certain groups are more susceptible to escalating costs. Therefore, increased screening and nuanced vaccination planning must be optimized in order to prevent and mitigate these growing cost burdens on vulnerable populations.
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Affiliation(s)
- David Uihwan Lee
- Division of Gastroenterology and Hepatology, University of Maryland, 22 S. Greene St, Baltimore, MD, 21201, USA.
| | - Kuntal Bhowmick
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Sindhura Kolachana
- Division of Gastroenterology and Hepatology, University of Maryland, 22 S. Greene St, Baltimore, MD, 21201, USA
| | - Kimberly Schuster
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Aneesh Bahadur
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Ashton Harmacinski
- Division of Gastroenterology and Hepatology, University of Maryland, 22 S. Greene St, Baltimore, MD, 21201, USA
| | - Sophie Schellhammer
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Gregory Hongyuan Fan
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Ki Jung Lee
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Catherine Sun
- Division of Gastroenterology and Hepatology, University of Maryland, 22 S. Greene St, Baltimore, MD, 21201, USA
| | - Hannah Chou
- Department of Medicine, Tufts University School of Medicine, Washington St, Boston, MA, 02111, USA
| | - Zurabi Lominadze
- Division of Gastroenterology and Hepatology, University of Maryland, 22 S. Greene St, Baltimore, MD, 21201, USA
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Zhou H, Yan M, Che D, Wu B. Trends in Mortality Related to Hepatitis B and C from 1990 to 2019 in the Western Pacific Region. Gut Liver 2024:gnl230023. [PMID: 38638100 DOI: 10.5009/gnl230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 04/20/2024] Open
Abstract
Background/Aims : This study aimed to analyze the trends in mortality attributed to hepatitis B and C around the Western Pacific region from 1990 to 2019. Methods : We used data from the Global Burden of Disease Study for a systematic analysis. The deaths related to hepatitis B and C were analyzed by age, sex, year, risk factors, geographical location, and Socio-demographic Index (SDI). Results : From 1990 to 2019, the annual total deaths from hepatitis B decreased from 0.266 to 0.210 million and those from hepatitis C increased from 0.119 to 0.142 million in the Western Pacific region. The age-standardized mortality rate (ASMR) of hepatitis B and C decreased by 63.5% and 48.0%, respectively. The declines in the ASMR related to hepatitis B and C were only detected in 12 and two Western Pacific countries, respectively. As the major risk factors, the contribution of alcohol use to hepatitis B deaths was 52% and drug use to hepatitis C was 80%. In males and females, the ASMR attributed to hepatitis B decreased by 61% and 71%, respectively, and the ASMR attributed to hepatitis C decreased by 43% and 55%, respectively. The association between SDI and ASMRs suggested that hepatitis B and C, respectively, showed an overall decline and stable trends as the SDI improved in the Western Pacific region. Conclusions : Although the mortality rate from hepatitis B and C decreased from 1990 to 2019, notable variation was observed among 27 Western Pacific countries. Efforts targeting hepatitis B and C prevention and treatment are still required in this region, especially for the pandemic countries.
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Affiliation(s)
- Hua Zhou
- Department of VIP, Shanghai Children's Hospital affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Mengxia Yan
- Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Datian Che
- Department of VIP, Shanghai Children's Hospital affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bin Wu
- Clinical Research Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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5
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Jonas MC, Sheu YS, Wright K, Peyton L, Bishop RC, Basra S, Sarwar F, Winn G, Chesbrough K. A care coordination program to support patients with hepatitis B virus at Kaiser Permanente Mid-Atlantic States. BMC Health Serv Res 2024; 24:482. [PMID: 38637807 PMCID: PMC11027294 DOI: 10.1186/s12913-024-10907-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Eliminating hepatitis B virus (HBV) is a significant worldwide challenge requiring innovative approaches for vaccination, screening, disease management, and the prevention of related conditions. Programs that support patients in accessing needed clinical services can help optimize access to preventive services and treatment resources for hepatitis B. METHODS Here, we outline a coordinator-supported program (HBV Pathway) that connects patients infected with HBV to laboratory testing, imaging, and specialty care for treatment initiation and/or liver cancer surveillance (screening of high-risk patients for liver cancer). This study describes the HBV Pathway steps and reports sociodemographic factors of patients by initiation and completion. RESULTS Results showed a 72.5% completion rate (defined as completing all Pathway steps including the final specialty visit) among patients who initiated the Pathway. Differences in completion were observed by age, race, ethnicity, and service area, with higher rates for younger ages, Asian race, non-Hispanic ethnicity, and lower rates for patients within one service area. Of those who completed the specialty visit, 59.5% were referred for hepatocellular carcinoma surveillance. CONCLUSIONS The HBV Pathway offers dual benefits- care coordination support for patients to promote Pathway completion and a standardized testing and referral program to reduce physician burden. This program provides an easy and reliable process for patients and physicians to obtain updated clinical information and initiate treatment and/or liver cancer screening if needed.
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Affiliation(s)
- M Cabell Jonas
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.
| | - Yi-Shin Sheu
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Kara Wright
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Lauren Peyton
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - R Clayton Bishop
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Sundeep Basra
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Fariha Sarwar
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Grace Winn
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
| | - Karen Chesbrough
- Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA
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Huang DQ, Shen L, Phyo WW, Cloherty G, Butler EK, Kuhns MC, McNamara AL, Holzmayer V, Jeffrey Gersch, Anderson M, Yang WL, Ngu JH, Chang J, Tan J, Ahmed T, Dan YY, Lee YM, Lee GH, Tan PS, Muthiah M, Wai Khine HT, Lee C, Tay A, Lim SG. Quantitative HBeAg is a strong predictor of HBeAg loss among patients receiving pegylated interferon. Antiviral Res 2024:105876. [PMID: 38641023 DOI: 10.1016/j.antiviral.2024.105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND HBeAg loss is an important endpoint for antiviral therapy in chronic hepatitis B (CHB), however there are no reliable biomarkers to identify patients who will respond to the addition of pegylated interferon to nucleos(t)ide analogue (NA) therapy. AIM To evaluate the use of serum biomarkers to predict HBeAg loss. METHODS HBeAg positive CHB participants on NAs who switched-to or added-on 48 weeks pegylated interferon alpha2b (clinicaltrial.gov NCT01928511) were evaluated at week 72 for HBeAg loss. The predictive ability of qHBeAg, qHBsAg, HBV RNA and clinical variables for HBeAg loss were investigated. RESULTS HBeAg loss occurred in 15/55 (27.3%) participants who completed 48 weeks of pegylated interferon. There was a lower baseline qHBeAg (1.18 IU/mL [2.27] versus 10.04 IU/mL [24.87], P = 0.007) among participants who lost HBeAg. Baseline qHBeAg (OR = 0.15, 95% CI 0.03-0.66, P = 0.01) and detectable HBV DNA at baseline (OR = 25.00, 95% CI 1.67-374.70, P = 0.02) were independent predictors of HBeAg loss. In addition, on-treatment qHBeAg was also a strong predictor of HBeAg loss (OR = 0.39, 95% CI 0.18-0.81, P = 0.012). The models combining detectable baseline HBV DNA with baseline (C-statistic 0.82) and on-treatment (C-statistic 0.83) had good accuracy for predicting HBeAg loss. A rise in qHBeAg ≥ 10 IU/ml was a predictor of flare (ALT ≥ 120 U/ml) on univariable analysis but not after adjustment for treatment arm. CONCLUSIONS Baseline and on-treatment qHBeAg is a useful biomarker that can identify participants on NA therapy who may benefit from adding or switching to pegylated interferon.
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Affiliation(s)
- Daniel Q Huang
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wah Wah Phyo
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | | | | | | | | | | | | | | | - Wei Lyn Yang
- Department of Gastroenterology, Tan Tock Seng Hospital, Singapore
| | | | - Jason Chang
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Jessica Tan
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Taufique Ahmed
- Department of Gastroenterology and Hepatology, Raja Isteri Pengiran Anak Saleha Hospital, Brunei
| | - Yock Young Dan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Yin Mei Lee
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Guan Huei Lee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Poh Seng Tan
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Mark Muthiah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Htet Toe Wai Khine
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Chris Lee
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Amy Tay
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Seng Gee Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore.
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Tu T, Wettengel J, Xia Y, Testoni B, Littlejohn M, Le Bert N, Ebert G, Verrier ER, Tavis JE, Cohen C. Major open questions in the hepatitis B and D field - Proceedings of the inaugural International emerging hepatitis B and hepatitis D researchers workshop. Virology 2024; 595:110089. [PMID: 38640789 DOI: 10.1016/j.virol.2024.110089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
The early and mid-career researchers (EMCRs) of scientific communities represent the forefront of research and the future direction in which a field takes. The opinions of this key demographic are not commonly aggregated to audit fields and precisely demonstrate where challenges lie for the future. To address this, we initiated the inaugural International Emerging Researchers Workshop for the global Hepatitis B and Hepatitis D scientific community (75 individuals). The cohort was split into small discussion groups and the significant problems, challenges, and future directions were assessed. Here, we summarise the outcome of these discussions and outline the future directions suggested by the EMCR community. We show an effective approach to gauging and accumulating the ideas of EMCRs and provide a succinct summary of the significant gaps remaining in the Hepatitis B and Hepatitis D field.
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Affiliation(s)
- Thomas Tu
- Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney at Westmead Hospital, Westmead, NSW, Australia; Centre for Infectious Diseases and Microbiology, Sydney Infectious Diseases Institute, The University of Sydney at Westmead Hospital, Westmead, NSW, Australia.
| | - Jochen Wettengel
- Division of Pathobiology and Immunology, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, 97006, USA; Institute of Virology, Technical University of Munich /Helmholtz Munich, Munich, Germany; German Center for Infection Research, Munich Partner Site, 81675, Munich, Germany
| | - Yuchen Xia
- State Key Laboratory of Virology and Hubei Province Key Laboratory of Allergy and Immunology, Institute of Medical Virology, TaiKang Center for Life and Medical Sciences, TaiKang Medical School, Wuhan University, Wuhan, China; Hubei Jiangxia Laboratory, Wuhan, China; Pingyuan Laboratory, Henan, China
| | - Barbara Testoni
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon, Lyon, France; University of Lyon, Université Claude-Bernard, Lyon, France; Hepatology Institute of Lyon, France
| | - Margaret Littlejohn
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital and Department of Infectious Disease, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Nina Le Bert
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Gregor Ebert
- Institute of Virology, Technical University of Munich /Helmholtz Munich, Munich, Germany
| | - Eloi R Verrier
- University of Strasbourg, Inserm, Institute for Translational Medicine and Liver Disease, UMR_S1110, Strasbourg, France
| | - John E Tavis
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine and the Saint Louis University Institute for Drug and Biotherapeutic Innovation, Saint Louis, MO, USA
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8
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Kushner T, Andrews RR. Addressing hepatitis delta in primary care practices in the US: a narrative review. Curr Med Res Opin 2024:1-8. [PMID: 38487951 DOI: 10.1080/03007995.2024.2318004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/07/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Infection with the hepatitis delta virus (HDV), a unique RNA virus that requires hepatitis B virus (HBV) antigens for its assembly, replication, and transmission, causes severe viral hepatitis. Compared to HBV monoinfection, HDV infection increases the risk of severe liver disease, necessity for liver transplant, and mortality. Global HDV prevalence estimates vary from 5% to 15% among persons with HBV, but screening guidelines for HDV are inconsistent; some recommend risk-based screening, while others recommend universal screening for all people with HBV. Among primary care providers (PCPs) in the US, there is a lack of awareness and/or insufficient adherence to current recommendations for the screening of HDV infection and management of chronic HDV. METHODS Publications were obtained by conducting literature searches between July and August 2022 using the PubMed database and by manual searches of the retrieved literature for additional references. Information was synthesized to highlight HDV screening and management strategies for PCPs. Best practices for PCPs based on current guidelines and comanagement strategies for patients with HBV and HDV infection were summarized. RESULTS We recommend universal screening for HDV in patients positive for hepatitis B surface antigen. Confirmed HDV infection should prompt evaluation by a liver specialist, if available, with whom the PCP can comanage the patient. PCPs should counsel patients on the expected course of the disease, lifestyle factors that may influence liver health, need for consistent disease monitoring and follow-up, and risk of disease transmission. Screening is suggested for sexual partners, household contacts, and family members, with HBV immunization recommended for those found to be susceptible. There are currently no US Food and Drug Administration-approved therapies for HDV infection; thus, management is limited to treatments for chronic HBV infection plus long-term monitoring of liver health. CONCLUSIONS PCPs can be a valuable point of care for patients to access HDV/HBV screening, HBV immunization, and education, and can comanage patients with HBV and/or HDV infection.
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Affiliation(s)
- Tatyana Kushner
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Çelik M, Baba C, Irmak Ç, Özakbaş S, Avkan-Oğuz V. Risk of hepatitis B virus reactivation in people with multiple sclerosis treated with ocrelizumab: an observational study from Turkey. J Neurol 2024:10.1007/s00415-024-12333-0. [PMID: 38578494 DOI: 10.1007/s00415-024-12333-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The risk of hepatitis B virus (HBV) reactivation remains unclear in people with multiple sclerosis (MS) receiving ocrelizumab. We aimed to assess HBV seroprevalence and reactivation risk in MS patients on ocrelizumab and to evaluate the effectiveness of antiviral prophylaxis against HBV reactivation. METHODS In this single-center, cross-sectional study, 400 people with MS receiving ocrelizumab were screened for HBV at baseline and antiviral prophylaxis was implemented based on serological results. Patients were monitored for HBV reactivation, and outcomes were analyzed. RESULTS Among 56 (14%) patients who had serology compatible with occult or resolved HBV infection, 49 (85.7%) received antiviral prophylaxis regularly and had no HBV reactivation during the follow-up. Reactivation of HBV occurred in 2 out of 7 (28.6%) patients who did not receive antiviral prophylaxis and in one patient who did not adhere to the prophylaxis regimen. All patients with reactivation had anti-HBs levels below 100 mIU/mL and the median titer was significantly lower than the patients with no HBV reactivation (p = 0.034). CONCLUSION This study highlights a 14% anti-HBc positivity, indicating a potential risk for HBV reactivation in people with MS receiving ocrelizumab. This suggests the importance of vigilant monitoring and the implementation of prophylactic measures. Our recommendation emphasizes antiviral prophylaxis, particularly for patients with low anti-HBs, and a pre-emptive strategy for others.
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Affiliation(s)
- Muammer Çelik
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, 35330, Izmir, Turkey.
| | - Cavid Baba
- Dokuz Eylul University, Graduate School of Health Sciences and Urla State Hospital, Izmir, Turkey
| | - Çağlar Irmak
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, 35330, Izmir, Turkey
| | - Serkan Özakbaş
- Faculty of Medicine, Department of Neurology, Izmir University of Economics, Izmir, Turkey
| | - Vildan Avkan-Oğuz
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, 35330, Izmir, Turkey
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10
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Freeland C, Adjei C, Wallace J, Wang S, Hicks J, Adda D, James C, Cohen C. Survey of lived experiences and challenges in hepatitis B management and treatment. BMC Public Health 2024; 24:944. [PMID: 38566070 PMCID: PMC10986103 DOI: 10.1186/s12889-024-18425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Almost 300 million people are living with chronic hepatitis B infection worldwide and most remain undiagnosed and at risk for liver cancer. In 2015 the World Health Organization (WHO) developed guidelines for the prevention, care, and treatment of persons with chronic hepatitis B and in early 2023 began to work on updating these guidelines. In March 2023, a self-administered, anonymous online survey was launched, aiming to identify patient preferences related to the clinical management of hepatitis B including current management, treatment, and care experiences, preferences regarding engagement with providers, and preferences related to simplifying hepatitis B care access. A sample of 560 individuals living with hepatitis B (self-identified as HBsAg positive) from 76 countries completed the survey. Key findings demonstrated that less than half (49%, N = 268) of participants regularly visited a doctor to check the health of their liver (every 6-12 months), with 37% of participants prescribed antiviral medication by a specialist (82%, N = 167) or general practitioner (13%, N = 26). Participants reported not being actively involved in care decision making with their providers (42%, N = 217), with an overwhelming majority wanting to participate in hepatitis B management and treatment choices (85%, N = 435). Participants provided qualitative and quantitative details using open-ended responses within the survey about challenges with medication affordability and receiving care from a knowledgeable provider. Overall findings demonstrated key gaps in care, management, and treatment access related to hepatitis B: identifying these gaps can be used to identify areas for improvement along the care continuum for viral hepatitis. The survey found a need for the comprehensive simplification of clinical management and health care services related to hepatitis B. A thematic analysis of the open-ended survey responses highlighted major overarching themes including the cost and access burdens associated with hepatitis B management and treatment, and challenges in finding knowledgeable providers. Results from this mixed methods survey were used to inform the WHO hepatitis B guidelines update. Efforts should continue to explore public health approaches to address barriers and facilitators to testing, care, and treatment for people with hepatitis B to improve awareness of hepatitis B and access, care, and treatment among patients and providers.
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Affiliation(s)
| | | | - Jack Wallace
- Burnet Institute, Melbourne, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Su Wang
- Saint Barnabas Medical Center, Livingston, NJ, USA
| | | | - Danjuma Adda
- World Hepatitis Alliance, London, UK
- CFID Taraba, Taraba, Nigeria
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11
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Copiz GI, Ibañez C, Piñera C, Cordova L, Payá E, Leal P, Villena R. Outcome of Infants Born to Women with Chronic Hepatitis B: A Local Risk-Based Strategy in a Low Prevalence Country. Matern Child Health J 2024; 28:767-774. [PMID: 38358537 DOI: 10.1007/s10995-024-03909-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Chronic hepatitis-B virus (HBV) infection due to mother-to-child transmission (MTCT) during the perinatal period is an important global health concern. Chile is a low-prevalence country with an increasing migratory inflow from Latin- American countries, with intermediate to high endemic rates of HBV infection, and until 2021, there is no universal maternal screening. This study aimed to evaluate infant outcomes using a risk-based strategy of maternal screening to prevent MTCT of hepatitis B virus (HBV) in a low-prevalence country. METHODS This prospective study included infants born to HBsAg-positive women detected using a local risk-based strategy. The exposed infants received immunoprophylaxis (IP) and follow-up to evaluate their clinical outcomes and immune responses through post-serological vaccine testing (PSVT) after completing the three- dose schedule of the HBV vaccine. RESULTS A total of 99 HBsAg-positive mothers were detected. Seventy-six (82%) infants completed the follow-up and had PSVT between 9 and 12 months of age. 55.2% female, the median gestational age was 39 weeks (25-41) and the median birth weight was 3,130g (816-4,400 g). All patients received IP with recombinant HBV vaccine plus hepatitis-B virus immunoglobulin (HBIG) and three doses of the HBV vaccine. There were no cases of HBV infection, and 96% (72) responded to immunization with HBsAg antibodies (anti-HBsAg) >10 UI/ml, with a median level of 799 IU/ml. CONCLUSIONS A high-risk strategy can be implemented in countries with non-universal screening for VHB. Timely IP plus high-uptake VHB vaccination in infants born to HBsAg-positive mothers was associated with a high immunogenic response and absence of MTCT.
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Affiliation(s)
- Giannina Izquierdo Copiz
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
- Maternity Ward and Neonatal Intensive Care Unit, Complejo Asistencial Barros Luco, Santiago, Chile.
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile.
| | - Carolina Ibañez
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
| | - Cecilia Piñera
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile
| | - Luis Cordova
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile
| | - Ernesto Payá
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile
| | - Paula Leal
- Infection Control Department, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile
| | - Rodolfo Villena
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, Santiago, Chile
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12
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Teiti I, Aubry M, Glaziou P, Mendiboure V, Teissier A, Paoaafaite T, Simon A, Chung K, Dian L, Olivier S, Pineau P, Fontanet A, Condat B, Madec Y, Lastère S, Cao-Lormeau VM. Towards elimination of chronic viral hepatitis in French Polynesia: results from a national population-based survey. Lancet Reg Health West Pac 2024; 45:101035. [PMID: 38445260 PMCID: PMC10914476 DOI: 10.1016/j.lanwpc.2024.101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/25/2024] [Accepted: 02/18/2024] [Indexed: 03/07/2024]
Abstract
Background In French Polynesia, hepatitis B virus (HBV) infection appears as a major risk factor for hepatocellular carcinoma (HCC), which detection rate in the Austral archipelago is among the highest in the world. Through a nationally representative cross-sectional survey of the adult population, this study aimed at assessing the prevalence of HBV, but also hepatitis C virus (HCV), and hepatitis delta virus (HDV). Methods A total of 1942 blood samples from participants aged 18-69 years were tested for anti-HBc, anti-HBs, HBsAg, anti-HCV IgG, and HDV RNA. Complete genome sequencing of detected HBV strains was performed. Findings Among participants, 315/1834, 582/1834, 33/1834, 0/1857, and 0/33 tested positive for anti-HBc, anti-HBs, HBsAg, anti-HCV IgG, and HDV RNA, respectively. The population prevalence of HBsAg was estimated at 1.0% (95% CI: 0.6-1.7). All HBsAg carriers were born in French Polynesia before vaccination at birth became mandatory. In multivariate analyses, identified factors associated with HBsAg carriage included: the archipelago of residence (p < 0.0001), age (p < 0.0001), and education level (p = 0.0077). HBV genotypes B, C, and F were detected. Interpretation French Polynesia has a low endemicity level of HBV and its population may be considered at low risk for HCV and HDV infection. However, prevalence of HBsAg was found concerning in Austral (3.8%; 95% CI: 1.9-7.5) and Marquesas (6.5%; 95% CI: 3.8-11) archipelagoes. In the Austral archipelago, the presence of genotype C may account for the elevated rate of HCC. Our findings warrant more efforts to improve access to detection, prevention and care to people born before the systematic vaccination policy application, and residing in higher-risk areas, to achieve HBV elimination in French Polynesia. Funding Research Delegation of French Polynesia.
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Affiliation(s)
- Iotefa Teiti
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Maite Aubry
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Philippe Glaziou
- Non-communicable Diseases Laboratory, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Vincent Mendiboure
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris 75015, France
| | - Anita Teissier
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Tuterarii Paoaafaite
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Aurélie Simon
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Kiyojiken Chung
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Lisa Dian
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Sophie Olivier
- Clinical Laboratory, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Pascal Pineau
- Institut Pasteur, Université Paris Cité, Unité“Organisation Nucléaire et Oncogenèse”, INSERM U993, Paris 75015, France
| | - Arnaud Fontanet
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris 75015, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | - Bertrand Condat
- Department of Gastroenterology, Centre Hospitalier de la Polynésie Française, Pirae, Tahiti, French Polynesia
| | - Yoann Madec
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris 75015, France
| | - Stéphane Lastère
- Clinical Laboratory, Centre Hospitalier de la Polynésie Française, Pirae, Tahiti, French Polynesia
| | - Van-Mai Cao-Lormeau
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
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13
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Yang J, Choi J. Linvencovir: Paving the way for functional cure in hepatitis B. Clin Mol Hepatol 2024; 30:164-165. [PMID: 38447533 PMCID: PMC11016477 DOI: 10.3350/cmh.2024.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Jiwon Yang
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jonggi Choi
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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14
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Shan S, Zhao X, Jia J. Comprehensive approach to controlling chronic hepatitis B in China. Clin Mol Hepatol 2024; 30:135-143. [PMID: 38176692 PMCID: PMC11016498 DOI: 10.3350/cmh.2023.0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/06/2024] Open
Abstract
Hepatitis B virus (HBV) infection was highly endemic in China, where the prevalence of HBsAg was 9.7% in 1992. Comprehensive strategies, including universal infant hepatitis B vaccination with emphasis on timely birth-dose and 3-dose coverage, dramatically reduced the mother-to-infant transmission and early childhood acquisition of HBV, resulting in estimated HBsAg prevalence rates of 5.6% and 0.1% in the general population and among children aged <5 years in 2022, respectively. Clinical guidelines on the prevention and treatment of chronic hepatitis B have been periodically updated based on emerging evidence from clinical research. The continuously improved reimbursement policy and the massively reduced price of antiviral drugs through government negotiation and central procurement have increased treatment accessibility and affordability. However, due to the low rates of diagnosis and treatment, China still faces a large challenge in achieving the 2030 goal of lowering HBV-related mortality by 65%. A public health approach involving concerted efforts from the government, medical community, industry, and society as a whole would be necessary to increase the uptake of HBV tests and treatment to achieve the global goal of eliminating viral hepatitis as a public health threat by 2030.
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Affiliation(s)
- Shan Shan
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, The National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Xinyan Zhao
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, The National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, The National Clinical Research Center for Digestive Diseases, Beijing, China
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15
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Abbas Z, Abbas M. Is there a need for universal double reflex testing of HBsAg-positive individuals for hepatitis D infection? World J Hepatol 2024; 16:300-303. [PMID: 38577532 PMCID: PMC10989316 DOI: 10.4254/wjh.v16.i3.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/16/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
Hepatitis D virus (HDV) can infect HBsAg-positive individuals, causing rapid fibrosis progression, early decompensation, increased hepatocellular carcinoma risk, and higher mortality than hepatitis B virus (HBV) mono-infection. Most countries lack high-quality HDV prevalence data, and the collection techniques employed often bias published data. In recent meta-analyses, HDV prevalence in HBsAg-positive patients reaches 5%-15% and is even significantly higher in endemic areas. Since HBV vaccination programs were implemented, HDV prevalence has decreased among younger populations. However, owing to immigrant influx, it has increased in some Western countries. The current practice of HDV screening in HBsAg-positive individuals is stepwise, based on physician's discretion, and limited to at-risk populations and may require numerous visits. Double reflex testing, which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones, is uncommon. Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up. Moreover, laboratory-based double reflex screening is less biased than physician-led testing. Therefore, healthcare providers should learn about reflex testing, and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates. The test's cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient. Such testing may be viable in areas with low HBsAg but high HDV prevalence. However, its economic impact on areas with low HDV prevalence needs further study.
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Affiliation(s)
- Zaigham Abbas
- Department of Hepatogastroenterology and Liver Transplantation, Dr. Ziauddin University Hospital, Karachi 75600, Sindh, Pakistan.
| | - Minaam Abbas
- Department of Medicine, University of Cambridge, Cambridge CB2 0SP, United Kingdom
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16
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Remera E, Tuyishime E, Kayitesi C, Malamba SS, Sangwayire B, Umutesi J, Ruisenor-Escudero H, Oluoch T. HIV and hepatitis B, C co-infection and correlates of HIV infection among men who have sex with men in Rwanda, 2021: a respondent-driven sampling, cross-sectional study. BMC Infect Dis 2024; 24:347. [PMID: 38521947 PMCID: PMC10960483 DOI: 10.1186/s12879-024-09206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are a key population group disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. In Rwanda, the HIV epidemic remains a significant public health concern, and understanding the burden of HIV and hepatitis B and C coinfections among MSM is crucial for designing effective prevention and control strategies. This study aims to determine the prevalence of HIV, hepatitis B, and hepatitis C infections among MSM in Rwanda and identify correlates associated with HIV infection within this population. METHODS We used respondent-driven sampling (RDS) to recruit participants between November and December 2021. A face-to-face, structured questionnaire was administered. Testing for HIV infection followed the national algorithm using two rapid tests: Alere Combo and STAT PAK as the first and second screening tests, respectively. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were performed. All statistics were adjusted for RDS design, and a multivariable logistic regression model was constructed to identify factors associated with HIV infection. RESULTS The prevalence of HIV among MSM was 6·9% (95% CI: 5·5-8·6), and among HIV-positive MSM, 12·9% (95% CI: 5·5-27·3) were recently infected. The prevalence of hepatitis B and C was 4·2% (95% CI: 3·0-5·7) and 0·7% (95% CI: 0·4-1·2), respectively. HIV and hepatitis B virus coinfection was 0·5% (95% CI: 0·2-1·1), whereas HIV and hepatitis C coinfection was 0·1% (95% CI: 0·0-0·5), and no coinfection for all three viruses was observed. MSM groups with an increased risk of HIV infection included those who ever suffered violence or abuse because of having sex with other men (AOR: 3·42; 95% CI: 1·87-6·25), those who refused to answer the question asking about 'ever been paid money, goods, or services for sex' (AOR: 10·4; 95% CI: 3·30-32·84), and those not consistently using condoms (AOR: 3·15; 95% CI: 1·31-7·60). CONCLUSION The findings suggest more targeted prevention and treatment approaches and underscore the importance of addressing structural and behavioral factors contributing to HIV vulnerability, setting interventions to reduce violence and abuse against MSM, promoting safe and consensual sexual practices, and expanding access to HIV prevention tools such as condoms and preexposure prophylaxis (PrEP).
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Affiliation(s)
- Eric Remera
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre (RBC) ), Kigali, Rwanda
| | - Elysee Tuyishime
- Division of Global HIV and TB, Global Health Center (GHC), US Centers for Disease Control and Prevention (CDC), Kigali, Rwanda.
| | - Catherine Kayitesi
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre (RBC) ), Kigali, Rwanda
| | - Samuel S Malamba
- Division of Global HIV and TB, Global Health Center (GHC), US Centers for Disease Control and Prevention (CDC), Kigali, Rwanda
| | - Beata Sangwayire
- Division of Global HIV and TB, Global Health Center (GHC), US Centers for Disease Control and Prevention (CDC), Kigali, Rwanda
| | - Justine Umutesi
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre (RBC) ), Kigali, Rwanda
| | - Horacio Ruisenor-Escudero
- Division of Global HIV and TB, Global Health Center (GHC), US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Tom Oluoch
- Division of Global HIV and TB, Global Health Center (GHC), US Centers for Disease Control and Prevention (CDC), Kigali, Rwanda
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Tamanna SS, Paul KD, Al Banna MH, Zannat Z, Paul AK, Sultana S, Alshahrani NZ, Talukder S, Hassan MN. Assessment of preventive practices towards hepatitis B infection among nursing students in Bangladesh: role of knowledge, attitudes and sociodemographic factors. BMC Nurs 2024; 23:190. [PMID: 38515143 PMCID: PMC10956232 DOI: 10.1186/s12912-024-01870-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Globally, hepatitis B infection (HBI) poses a substantial public health concern and healthcare workers, including nursing students, are at a higher risk of contracting this disease. Thus, the study aimed to assess how knowledge, attitudes, and sociodemographic factors are associated with HBI prevention among a sample of Bangladeshi nursing students. METHODS A cross-sectional survey was performed among 737 nursing students from the nursing institutes of Khulna and Barishal divisions in Bangladesh from January to April 2023. The data were collected by providing questionnaires (structured questionnaire) in the classroom, following a stratified random sampling process. A model of multinomial logistic regression was used to evaluate the factors linked to HBI prevention practices. RESULT The mean (SD) scores were 11.42 (± 2.88) for knowledge, 4.33 (± 1.91) for attitude and 4.27 (± 2.056) for practice respectively. Participants' low knowledge (adjusted odds ratio, aOR = 2.562, 95% CI: 1.29-5.07) and poor attitude (aOR = 5.730, 95% CI: 3.19-10.28) regarding HBI were significantly associated with higher likelihood of poor practice towards HBI prevention. Moreover, being 2nd year of nursing students (aOR = 2.147, 95% CI: 1.19-3.86), being aged 19-20 years (aOR = 3.038, 95% CI: 1.30-7.09), being married (aOR = 0.320, 95%CI: 0.13-0.82) and having a family history of HBI (aOR = 0.134, 95%CI: 0.05-0.36) were significantly associated with poor practices of HBI prevention among study participants. CONCLUSION The knowledge, attitude and practice scores of the nursing students on HBI prevention were suboptimal. We advocate for implementing regular HBI prevention education and policies, free or subsidized services, skill development, proper HBI prevention enforcement and strict professional ethics within nursing colleges. Such efforts should predominantly focus on second-year, aged 19-20 and unmarried nursing students.
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Affiliation(s)
- Sumaiya Sultana Tamanna
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Kallol Deb Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | - Zamia Zannat
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Anup Kumar Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Sadia Sultana
- Department of Mathematics, University of Barishal, Barishal, 8254, Bangladesh
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Sohan Talukder
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Md Nazmul Hassan
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
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Kimera A, Atuyambe L, Mutyaba H, Nantongo C, Namagembe A, Nalumansi AM, Basenero A, Auma P, Mukiza N, Mutyoba J. Prevalence and factors associated with hepatitis b vaccination uptake and completion among communities targeted for mass vaccination in gulu: a cross-sectional study. BMC Public Health 2024; 24:866. [PMID: 38509496 PMCID: PMC10956285 DOI: 10.1186/s12889-024-18330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is associated with several acute and long-term complications and vaccination is the cornerstone of prevention. A recent outbreak in Gulu, Uganda, one of the districts covered by a mass vaccination campaign, suggests low uptake of HBV vaccination. This study aims to determine the uptake and completion of HBV vaccination and associated factors among residents of Gulu, Uganda. METHODS A mixed methods cross-sectional study was conducted in Gulu, Northern Uganda, among 434 adult residents. A pretested questionnaire was used to collect data on socio-demographics, perceptions, and knowledge of HBV vaccination. Modified Poisson regression analysis was used in STATA 14 software to obtain prevalence ratios for the association between the independent and dependent variables. For qualitative data, 9 key informant interviews were conducted and thematic analysis was done using Quirkos software. RESULTS Out of the 434 respondents, 41.9% had received at least one dose of the hepatitis B vaccine, 32.5% had received at least 2 doses, and only 20% had completed all 3 doses, with an overall completion rate of 47.8% for participants who had been initiated on the vaccine. Gender, residence, risk perception of Hepatitis B infection, perceived safety of the vaccine, and awareness of mass vaccination were associated with uptake of Hepatitis B vaccination. Residence, knowledge, and perception of being at risk of acquiring Hepatitis B were associated with completion. Qualitative results revealed that the levels of uptake and completion could have been affected by access to vaccination sites; inadequate knowledge about the disease; myths about the vaccine and inadequate community engagement. CONCLUSION Low Hepatitis B vaccine uptake and completion rates were observed in Gulu. To enhance vaccination coverage, future initiatives should prioritize awareness, education, and dispelling of vaccination myths. Additionally, increased government investment in training health workers can serve as a valuable strategy to improve information dissemination and awareness among the population.
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Affiliation(s)
- Andrew Kimera
- Makerere University College of Health Sciences, Kampala, Uganda.
| | - Lynn Atuyambe
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Huzaifa Mutyaba
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Claire Nantongo
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Agnes Namagembe
- Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | | | | | - Joan Mutyoba
- Makerere University College of Health Sciences, Kampala, Uganda
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Price O, Swanton R, Grebely J, Hajarizadeh B, Webb P, Peacock A, Dore GJ, Cowie BC, Vickerman P, Degenhardt L. Vaccination coverage among people who inject drugs: A systematic review. Int J Drug Policy 2024; 127:104382. [PMID: 38503233 DOI: 10.1016/j.drugpo.2024.104382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND People who inject drugs may be at excess risk of acquiring vaccine-preventable diseases and negative associated health outcomes, but experience barriers to vaccination. We aimed to determine vaccination coverage among people who inject drugs globally. METHODOLOGY We conducted systematic searches of the peer-reviewed and grey literature, date limited from January 2008 to August 2023, focusing on diseases for which people who inject drugs are at elevated risk for and for which an adult vaccination dose is recommended (COVID-19, hepatitis A, hepatitis B, human papillomavirus, influenza, pneumococcal disease, tetanus). To summarise available data, we conducted a narrative synthesis. RESULTS We included 78 studies/reports comprising 117 estimates of vaccination coverage across 36 countries. Most estimates were obtained from high income countries (80%, n=94). We located estimates for hepatitis B vaccination in 33 countries, which included 18 countries with data on serological evidence of vaccine-derived hepatitis B immunity (range: 6-53%) and 22 countries with self-report data for vaccine uptake (<1-96%). Data for other vaccines were scarcer: reported hepatitis A vaccination coverage ranged 3-89% (five countries), COVID-19 ranged 4-84% (five countries), while we located estimates from fewer than five countries for influenza, tetanus, pneumococcal disease, and human papillomavirus. CONCLUSION Estimates were sparse but where available indicative of suboptimal vaccination coverage among people who inject drugs. Improving the consistency, timeliness, and geographic coverage of vaccine uptake data among this population is essential to inform efforts to increase uptake.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
| | - Rosie Swanton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | | | | | - Paige Webb
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | | | - Benjamin C Cowie
- Department of Infectious Diseases, University of Melbourne, Melbourne, Australia; WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, Melbourne, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia
| | - Peter Vickerman
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
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Sperle I, Lassen SG, Schlaud M, Dörre A, Dudareva S, Poethko-Müller C, Harder T. Prevalence of vaccine-derived hepatitis B surface antibodies in children and adolescents in Germany: results from a population-based survey, 2014-2017. BMC Infect Dis 2024; 24:318. [PMID: 38491438 PMCID: PMC10941582 DOI: 10.1186/s12879-024-09201-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/06/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Childhood vaccination against hepatitis B has been recommended in Germany since 1995. WHO defines a primary vaccination series as successful if the initial hepatitis B surface antibody (anti-HBs) level is ≥ 10 IU/L directly after vaccination. Anti-HBs levels vary depending on the number of doses, type of vaccine, and time interval between the last two doses. In 2021, Germany began to recommend three instead of four doses of polyvalent hepatitis-B-containing vaccines. Our aim was to estimate the proportion of vaccinated children in Germany with anti-HBs levels < 10 IU/L, 10-99 IU/L, and ≥ 100 IU/L by number and type of vaccine, and assess if number of doses and compliance with recommended time interval between the last two doses are associated with an anti-HBs level ≥ 10 IU/L when considering type of vaccine and time since last dose. METHODS We used data from a national cross-sectional study (2014-2017) of children (3-17 years). We excluded participants with unknown vaccination dates, unreadable or incomplete vaccination cards, and hepatitis B virus (HBV)-positive participants. We defined a recommended schedule as a vaccination series with at least six months between the two last doses and having three doses or more. We calculated weighted anti-HBs sero-prevalence for three anti-HBs levels: < 10 IU/L, 10-99 IU/L and ≥ 100 IU/L. We fitted two logistic regression models to examine the relationship between number of doses and recommended schedule on anti-HBs levels (≥ 10 IU/L and ≥ 100 IU/L) considering time since last dose and type of vaccine (Infanrix, Hexavac, Monovalent). RESULTS We included 2,489 participants. The weighted proportion of vaccinated children per anti-HBs level was < 10 IU/L: 36.3% [95%CI 34.0-38.7%], 10-99 IU/L: 35.7% [33.2-38.2%] and ≥ 100 IU/L: 28.0% [25.9-30.2%]. We did not find an association between a recommended schedule of three versus four doses and anti-HBs ≥ 10 IU/L or ≥ 100 IU/L. CONCLUSIONS Anti-HBs levels in later childhood were about equal, whether children received three or four doses. This implies that the change in the recommendations does not affect the anti-HBs level among children in Germany. Future studies are needed on the association of anti-HBs levels and adequate sustained protection against HBV.
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Affiliation(s)
- Ida Sperle
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany.
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Sofie Gillesberg Lassen
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- PhD Programme, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Achim Dörre
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sandra Dudareva
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Thomas Harder
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Ly KN, Yin S, Spradling PR. Disparities in Social Vulnerability and Premature Mortality among Decedents with Hepatitis B, United States, 2010-2019. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01968-4. [PMID: 38472630 DOI: 10.1007/s40615-024-01968-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Current US hepatitis B mortality rates remain three times higher than the national target. Mortality reduction will depend on addressing hepatitis B disparities influenced by social determinants of health. OBJECTIVES This study aims to describe characteristics of hepatitis B-listed decedents, which included US birthplace status and county social vulnerability attributes and quantify premature mortality. METHODS We conducted a cross-sectional analysis of 17,483 hepatitis B-listed decedents using the 2010-2019 US Multiple-Cause-of-Death data merged with the county-level Social Vulnerability Index (SVI). Outcomes included the distribution of decedents according to US birthplace status and residence in higher versus lower death burden counties by sociodemographic characteristics, years of potential life lost (YPLL), and SVI quartiles. RESULTS Most hepatitis B-listed decedents were US-born, male, and born during 1945-1965. Median YPLL was 17.2; 90.0% died prematurely. US-born decedents were more frequently White, non-college graduates, unmarried, and had resided in a county with < 500,000 people; non-US-born decedents were more frequently Asian/Pacific Islander, college graduates, married, and had resided in a county with ≥ 1 million people. Higher death burden (≥ 20) counties were principally located in coastal states. US-born decedents more frequently resided in counties in the highest SVI quartile for "Household Characteristics" and "Uninsured," whereas non-US-born decedents more frequently resided in counties in the highest SVI quartile for "Racial/Ethnic Minority Status" and "Housing Type/Transportation." CONCLUSION This analysis found substantial premature hepatitis B mortality and residence in counties ranked high in social vulnerability. Successful interventions should be tailored to disproportionately affected populations and the social vulnerability features of their geographic areas.
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Affiliation(s)
- Kathleen N Ly
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop US12-3, Atlanta, GA, 30333, USA.
| | - Shaoman Yin
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop US12-3, Atlanta, GA, 30333, USA
| | - Philip R Spradling
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop US12-3, Atlanta, GA, 30333, USA.
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22
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Sarhadi M, Pahlavani E, Hosseini Razavi N, Ghadyani F, Abdollahi Z, Sarhadi S, Sabeti Akbar Abad M, Shahriari H, Majidpour M. IL-18 and CD14 variants in chronic HBV predisposition: a case-control study with in silico analyses focused on transcription and splicing. Nucleosides Nucleotides Nucleic Acids 2024:1-21. [PMID: 38459706 DOI: 10.1080/15257770.2024.2326132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
Hepatitis B virus (HBV), a vaccine-avoidable infection, is a health concern worldwide, leading to liver disorders such as acute self-constraint and chronic hepatitis, liver failure, hepatic cirrhosis, and even hepatocellular carcinoma if untreated. 'Immunogeneticprofiling', genetic variations of the pro- and anti-inflammatory cytokines responsible for regulating the immune responses, cause person-to-person differences and impact the clinical manifestation of the disease. The current experimental-bioinformatics research was conducted to examine whether promoteric IL-18-rs187238 C > G and -rs1946518 T > G and intronic CD14-rs2569190 A > G variations are associated with chronic HBV. A total of 400 individuals (200 in each case and control group) participated in the study and were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The data was also assessed bioinformatics-wise for conservation, genomic transcription and splicing, and protein interactions. Findings proposed that unlike the IL-18-rs1946518 T > G and CD14-rs2569190 A > G, the IL-18-rs187238 C > G is a protector against chronic HBV (odds ratio [OR] = 0.62, 95% confidence intervals [CI]: 0.46-0.83, and p = 0.002). The TG/CC/AA, TG/CC/AG, TT/CC/AG, and GG/CC/AA combined genotypes significantly increased chronic HBV risk (p < 0.05), while the IL-18 G/T and G/G haplotypes lessened it (p < 0.05). Moreover, IL-18-rs1946518 T > G is in the protected genomic regions across mammalian species. In contrast to the IL-18-rs1946518 T > G, IL-18-rs187238 C > G is likely to create novel binding sites for transcription factors, and the CD14-rs2569190 A > G presumably changed the ribonucleic acid splicing pattern. More research on larger populations and other ethnicities is required to authenticate these results.
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Affiliation(s)
- Mohammad Sarhadi
- Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Elham Pahlavani
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Niloufar Hosseini Razavi
- Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fatemeh Ghadyani
- Department of Cellular and Molecular, Faculty of Biology Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - Zahra Abdollahi
- Department of Cell and Molecular Biology, Faculty of Chemistry, University of Kashan, Kashan, Iran
| | - Somayeh Sarhadi
- Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mahboobeh Sabeti Akbar Abad
- Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Clinical Biochemistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hossein Shahriari
- Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Majidpour
- Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Clinical Biochemistry, Zahedan University of Medical Sciences, Zahedan, Iran
- Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Heller T, Phiri V, Kumwenda T, Mzumara W, Vinikoor MJ, Rambiki E, Wallrauch C. Point-of-care ultrasound to inform antiviral treatment initiation in chronic hepatitis B virus infection in low-resource settings - the PUSH protocol. Ultrasound J 2024; 16:18. [PMID: 38436778 PMCID: PMC10912069 DOI: 10.1186/s13089-024-00369-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Chronic Hepatitis B (CHB) is prevalent worldwide and most related deaths occur in low-resource settings. Antiviral treatment of CHB is indicated in those with significant liver disease and markers of viral replication. However, recommended diagnostics such as elastography (a non-invasive imaging measure of fibrosis/cirrhosis) or HBV viral load are often lacking in these settings, which creates barriers to treatment. Point-of-care clinical B-mode ultrasound (US) has potential to overcome implementation barriers in HBV care programs in low-resource settings. METHODS We describe a Point-of-care US protocol for Hepatitis ("PUSH") to check for signs of cirrhosis and hepatocellular carcinoma in the liver of people with CHB. We performed a prospective observational study applying the protocol, first by trainee clinicians and then by trainers, in consecutive patients referred to our clinic for CHB treatment eligibility assessment. All patients additionally underwent physical examination, liver function tests (LFTs) and platelet counts. We describe the PUSH training approach and performance of the protocol. RESULTS Four clinicians and 111 adult patients with HBV infection were included in the development of PUSH. Using US, liver complications of HBV were documented in 31 (27.9%) patients; including cirrhosis in 15 patients, HCC with cirrhosis in 13, and HCC without cirrhosis in 3. Patients with sonographic findings had significantly more clinical symptoms also their LFTs were higher and more frequently indicative for HBV treatment. Of 28 patients with sonographic diagnosis of cirrhosis, 23 (82.1%) showed a nodular liver surface, 24 (85.7%) a coarse echotexture, 20 (71.4%) scarce vessels, and 9 (32.1%) an enlarged caudate lobe. Overall concordance of the findings between assessment of trainees and experienced sonographers was high, ranging from 90 to 95%; trainees were not blinded to clinical and laboratory findings. CONCLUSION Ultrasound can facilitate same-day initiation of antiviral therapy for chronic HBV monoinfection in a resource-limited setting and a streamlined protocol-driven liver ultrasound can be feasibly used by front line clinicians managing HBV.
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Affiliation(s)
- Tom Heller
- Lighthouse Clinic Trust, Lilongwe, Malawi.
- International Training and Education Center for Health, University of Washington, Seattle, WA, USA.
| | | | | | - Wongani Mzumara
- Directorate of HIV/AIDS, STI and Viral Hepatitis, Ministry of Health, Lilongwe, Malawi
| | - Michael Jeffrey Vinikoor
- Department of Internal Medicine, University of Zambia, Lusaka, Zambia
- University of Alabama at Birmingham, Birmingham, AL, USA
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24
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Pahwa P, Vyas AK, Sevak JK, Singh R, Maras JS, Patra S, Sarin SK, Trehanpati N. Modulation of CD8 +T cells, NK cells and Th1cytokines by metabolic milieu in decline of HBV-viremia in pregnant women treated with tenofovir-disoproxil from second trimester of pregnancy. J Reprod Immunol 2024; 162:104208. [PMID: 38367478 DOI: 10.1016/j.jri.2024.104208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/04/2024] [Accepted: 01/24/2024] [Indexed: 02/19/2024]
Abstract
High HBV DNA levels predispose to mother to child transmission (MTCT) of HBV. Early nucleotide analogue (NA) therapy can reduce HBV DNA and minimize MTCT. We analysed immune-metabolic profile in pregnant mothers who received NA from 2nd trimester compared with untreated mothers. In 2nd trimester, there was no difference in immune profiles between Gr.1 and Gr.2 but high viral load women had downregulated pyruvate, NAD+ metabolism but in 3rd trimester, Gr.1 had significant reduction in HBV-DNA, upregulated pyruvate and NAD with increased IFN-2αA, CD8Tcells, NK cells and decreased Tregs, IL15, IL18, IL29, TGFβ3 compared to Gr.2. In Gr.1, three eAg-ve women showed undetectable DNA and HBsAg. At delivery, Gr.1 showed no MTCT, with undetectable HBV DNA, HBsAg, high CD8 and NK cells in two women. We conclude, that starting NA from second trimester, reduces HBV load and MTCT, modulates NAD, induces immunity and suggest use of NA in early gestation in future trials.
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Affiliation(s)
- Prabhjyoti Pahwa
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ashish Kumar Vyas
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jayesh Kumar Sevak
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ravinder Singh
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jaswinder Singh Maras
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Sharda Patra
- Department of Obstetrics and Gynaecology, Lady Harding Medical College, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
| | - Nirupama Trehanpati
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.
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Kanduri SR, Peleg Y, Wadhwani S. Liver Disease-Associated Glomerulopathies. Adv Kidney Dis Health 2024; 31:147-156. [PMID: 38649219 DOI: 10.1053/j.akdh.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/11/2023] [Accepted: 11/22/2023] [Indexed: 04/25/2024]
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infect a significant number of individuals globally and their extra-hepatic manifestations, including glomerular disease, are well established. Additionally, liver disease-associated IgA nephropathy is the leading cause of secondary IgA nephropathy with disease course varying from asymptomatic urinary abnormalities to progressive kidney injury. Herein we provide an updated review on the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis as well as IgA nephropathy in patients with liver disease. The most common HBV-related glomerulonephritis is membranous nephropathy, although membranoproliferative glomerulonephritis and podocytopathies have been described. The best described HCV-related glomerulonephritis is cryoglobulinemic glomerulonephritis occurring in about 30% of patients with mixed cryoglobulinemic vasculitis. The mainstay of treatment for HBV-GN and HCV-GN is antiviral therapy, with significant improvement in outcomes since the emergence of the direct-acting antivirals. However, cases with severe pathology and/or a more aggressive disease trajectory can be offered a course of immunosuppression, commonly anti-CD20 therapy, particularly in the case of cryoglobulinemic glomerulonephritis.
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Affiliation(s)
- Swetha R Kanduri
- Department of Nephrology, Ochsner Health System, New Orleans, LA; Ochsner Clinical School, The University of Queensland, New Orleans, LA.
| | - Yonatan Peleg
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Shikha Wadhwani
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL
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Hayes MJ, Beavon E, Traeger MW, Dillon JF, Radley A, Nielsen S, Byrne CJ, Richmond J, Higgs P, Hellard ME, Doyle JS. Viral hepatitis testing and treatment in community pharmacies: a systematic review and meta-analysis. EClinicalMedicine 2024; 69:102489. [PMID: 38440399 PMCID: PMC10909633 DOI: 10.1016/j.eclinm.2024.102489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 03/06/2024] Open
Abstract
Background The World Health Organization seeks to eliminate viral hepatitis as a public health threat by 2030. This review and meta-analysis aims to evaluate the effectiveness of programs for hepatitis B and C testing and treatment in community pharmacies. Methods Medline, Embase, Cochrane CENTRAL, and Global Health were searched from database inception until 12 November 2023. Comparative and single arm intervention studies were eligible for inclusion if they assessed delivery of any of the following interventions for hepatitis B or C in pharmacies: (1) pre-testing risk assessment, (2) testing, (3) pre-treatment assessment or (4) treatment. Primary outcomes were proportions testing positive and reaching each stage in the cascade. Random effects meta-analysis was used to estimate pooled proportions stratified by recruitment strategy and setting where possible; other results were synthesised narratively. This study was pre-registered (PROSPERO: CRD42022324218). Findings Twenty-seven studies (4 comparative, 23 single arm) were included, of which 26 reported hepatitis C outcomes and four reported hepatitis B outcomes. History of injecting drug use was the most identified risk factor from pre-testing risk assessments. The pooled proportion hepatitis C antibody positive from of 19 studies testing 5096 participants was 16.6% (95% CI 11.0%-23.0%; heterogeneity I2 = 96.6%). The pooled proportion antibody positive was significantly higher when testing targeted people with specified risk factors (32.5%, 95% CI 24.8%-40.6%; heterogeneity I2 = 82.4%) compared with non-targeted or other recruitment methods 4.0% (95% CI 2.1%-6.5%; heterogeneity I2 = 83.5%). Meta-analysis of 14 studies with 813 participants eligible for pre-treatment assessment showed pooled attendance rates were significantly higher in pharmacies (92.7%, 95% CI 79.1%-99.9%; heterogeneity I2 = 72.4%) compared with referral to non-pharmacy settings (53.5%, 95% CI 36.5%-70.1%; heterogeneity I2 = 92.3%). The pooled proportion initiating treatment was 85.6% (95% CI 74.8%-94.3%; heterogeneity I2 = 75.1%). This did not differ significantly between pharmacy and non-pharmacy settings. Interpretation These findings add pharmacies to the growing evidence supporting community-based testing and treatment for hepatitis C. Few comparative studies and high degrees of statistical heterogeneity were important limitations. Hepatitis B care in pharmacies presents an opportunity for future research. Funding None.
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Affiliation(s)
| | | | - Michael W. Traeger
- Burnet Institute, Melbourne, Australia
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, USA
| | - John F. Dillon
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, UK
- Department of Gastroenterology, Ninewells Hospital and Medical School, Dundee, UK
| | - Andrew Radley
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, UK
- NHS Tayside, Dundee, UK
| | - Suzanne Nielsen
- Burnet Institute, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Christopher J. Byrne
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, UK
- NHS Tayside, Dundee, UK
| | | | - Peter Higgs
- Burnet Institute, Melbourne, Australia
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Margaret E. Hellard
- Burnet Institute, Melbourne, Australia
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, USA
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Joseph S. Doyle
- Burnet Institute, Melbourne, Australia
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia
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Boglione L, Lupia T, Stroffolini G, Dodaro V, Perri GD. HBsAg kinetics after 7 years of therapy with tenofovir disoproxil fumarate in a cohort of naïve patients affected by chronic hepatitis B with different genotypes. Infect Med (Beijing) 2024; 3:100087. [PMID: 38450105 PMCID: PMC10915551 DOI: 10.1016/j.imj.2024.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 03/08/2024]
Abstract
The role of different genotypes in nucleos(t)ide analogs (NAs) treatment is still debated. Previous studies conducted on special populations evidenced that the E genotype had the lower virological and serological response. This descriptive study aims to recognize the hepatitis B "s" antigen (HBsAg) decline during tenofovir disoproxil fumarate (TDF) treatment in a cohort of patient affected by chronic hepatitis B (CHB). We retrospectively included all patients with CHB treated with TDF between April 2007 and March 2012 with a duration of treatment of 7 years. Kinetics of HBsAg was determined as serological response in this cohort. We include 110 subjects; virological response was observed in all subjects with genotypes A, B, and D; in 17 patients with C genotype (94.4%) and 24 with E genotype (96%). HBeAg loss was observed in 2 patients with genotype A (50%), 3 with B (100%), 0 with C (0%), 1 with D (20%), and 1 with E genotype (25%). In multivariate analysis we observed as predictive factors of HBsAg decline the baseline level of HBsAg (OR = 1.467; 95%CI: 1.221-5.113; p = 0.017) and viral genotypes (OR = 11.218; 95%CI: 5.441-41.138; p < 0.001). This study confirmed higher HBsAg decline after 7 years of treatment in A and B genotypes, and lower in C, E, and D genotypes. However, no evidence is enough to choose a single NAs, but in special populations, as well as in genotype E, the use of TDF should be preferred to entecavir.
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Affiliation(s)
- Lucio Boglione
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Tommaso Lupia
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Giacomo Stroffolini
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Valentina Dodaro
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Giovanni Di Perri
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
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Brandl M, Ceban A, Sajin O, Bucov V, Cataraga A, Stratulat S, Furtuna N, Gutu V, Gheorghita S, Gassowski M, Mosina L, Mozalevskis A, Dudareva S, Datta SS. Evaluating the hepatitis B vaccination impact in the Republic of Moldova: A nationwide representative serosurvey of children born in 2013. IJID Reg 2024; 10:60-66. [PMID: 38384785 PMCID: PMC10881275 DOI: 10.1016/j.ijregi.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 02/23/2024]
Abstract
Objectives The WHO European Region set targets for the control of hepatitis B through immunization, including prevalence of hepatitis B surface antigen (HBsAg) at ≤0.5% in vaccinated cohorts. The Republic of Moldova implemented universal hepatitis B vaccination since 1995. We conducted a nationwide representative serosurvey to estimate HBsAg seroprevalence in children born in 2013 to validate hepatitis B control targets. Methods We used probability-based sampling and a two-stage cluster design. All children born in 2013 and registered in primary healthcare facilities were eligible for participation. We tested blood samples of all participants for hepatitis B core antibody (anti-HBc), using Enzyme-Linked Immunosorbent Assay (ELISA). Anti-HBc-positive samples were tested for HBsAg and HBsAg-positive samples confirmed, using ELISA. We obtained information on hepatitis B vaccination from vaccination cards. Results Of 3352 sampled children, 3064 (91%) participated. Most participating children were 7 years old (n = 3030, 99%), 1426 (48%) were girls. The weighted, national seroprevalence estimate was 3.1% (95% confidence interval = 2.1-4.5) for anti-HBc and 0.21% (95% confidence interval = 0.08-0.53) for HBsAg. Conclusion The study demonstrated the impact of hepatitis B vaccination and allowed the Republic of Moldova to validate regional hepatitis B control targets. Other countries with high vaccination coverage could use hepatitis B serosurveys and apply for validation. Sustained efforts in the Republic of Moldova will be crucial on the path to hepatitis B elimination.
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Affiliation(s)
- Michael Brandl
- Robert Koch Institute, Dept. of Infectious Disease Epidemiology, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexei Ceban
- WHO Country Office in the Republic of Moldova, Chisinau, Republic of Moldova
| | - Octavian Sajin
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Victoria Bucov
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Alina Cataraga
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Silvia Stratulat
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Nicolae Furtuna
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Veaceslav Gutu
- National Agency for Public Health, Chisinau, Republic of Moldova
| | - Stela Gheorghita
- WHO Country Office in the Republic of Moldova, Chisinau, Republic of Moldova
| | - Martyna Gassowski
- Robert Koch Institute, Dept. of Infectious Disease Epidemiology, Berlin, Germany
| | | | | | - Sandra Dudareva
- Robert Koch Institute, Dept. of Infectious Disease Epidemiology, Berlin, Germany
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Bwala KJ, Muhammed MM, Mohammed A, Mienda IS, Liman HU. Knowledge of Hepatitis B Vaccine and Vaccination Status of Theatre Personnel at ATBUTH, Bauchi. West Afr J Med 2024; 41:191-196. [PMID: 38583065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
BACKGROUND Hepatitis B virus infection affects millions of people worldwide and is transmitted vertically and through contact with infected blood or body fluids. Frontline Healthcare workers are at increased risk of contracting HBV infection and the HBV vaccine is a crucial preventive measure recommended by WHO to safeguard healthcare workers. OBJECTIVES To investigate the awareness and knowledge of hepatitis B virus infection, to evaluate current vaccination status among theatre personnel, and to identify factors influencing vaccine uptake. METHODOLOGY This is a cross-sectional study conducted among 85 theatre personnel of ATBUTH Bauchi. Convenience sampling method was used to select participants, each participant gave consent to participate in this study. A structured questionnaire was used to collect data, which was analysed using SPSS version 25. RESULT Hepatitis B virus vaccine is safe according to 85% of respondents, 92% agreed that they would recommend the vaccine to other surgical staff and that it should be given as part of workplace safety. However, only 33% of respondents had completed their vaccination, while 31% had not started. The main reasons given for not being vaccinated were because they had no time to attend and did not know about the vaccine or did not have enough information regarding it. CONCLUSION The majority of study respondents were aware of and had a good knowledge of HBV and its' vaccine. However, vaccination status is very low among theatre personnel of ATBUTH Bauchi. Healthcare workers should be enlightened about the benefits of the HBV vaccine.
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Affiliation(s)
- K J Bwala
- Department of Surgery, Abubakar Tafawa Balewa University, Bauchi
- Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
| | - M M Muhammed
- Department of Surgery, Abubakar Tafawa Balewa University, Bauchi
- Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
| | - A Mohammed
- Internal Medicine Department, Federal University of Heath Sciences Azare, Bauchi State
| | - Isa Sajo Mienda
- Department of Surgery, Abubakar Tafawa Balewa University, Bauchi
- Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
| | - H U Liman
- Department of Surgery, Abubakar Tafawa Balewa University, Bauchi
- Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
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Musafiri T, Kamali I, Kayihura C, de la Paix Gakuru J, Nyirahabihirwe F, Nizeyimana E, Kandamage P, Habinshuti P, Sekagarura R, Makuza JD, Karema N, Serumondo J, Ntakirutimana T, Ndahimana JD, Barnhart DA. Prevalence of hepatitis B and C infection and linkage to care among patients with Non-Communicable Diseases in three rural Rwandan districts: a retrospective cross-sectional study. BMC Infect Dis 2024; 24:247. [PMID: 38388353 PMCID: PMC10885378 DOI: 10.1186/s12879-023-08678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/06/2023] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Rwanda's Hepatitis C elimination campaign has relied on mass screening campaigns. An alternative "micro-elimination" strategy focused on specific populations, such as non-communicable disease (NCD) patients, could be a more efficient approach to identifying patients and linking them to care. METHODS This retrospective cross-sectional study used routine data collected during a targeted screening campaign among NCD patients in Kirehe, Kayonza, and Burera districts of Rwanda and patients receiving oncology services from the Butaro District Hospital. The campaign used rapid diagnostic tests to screen for Hepatitis B surface antigen (HBsAg) and Hepatitis C antibody (anti-HCV). We reported prevalences and 95% confidence intervals for HBsAg and anti-HCV, assessed for associations between patients' clinical programs and hepatitis B and C, and reported cascade of care for the two diseases. RESULTS Out of 7,603 NCD patients, 3398 (45.9%) self-reported a prior hepatitis screening. Prevalence of HBsAg was 2.0% (95% CI: 1.7%-2.3%) and anti-HCV was 6.7% (95% CI: 6.2%-7.3%). The prevalence of HBsAg was significantly higher among patients < 40 years (2.4%). Increased age was significantly associated with anti-HCV (12.0% among patients ≥ 70 years). Of the 148 individuals who screened positive for HbsAg, 123 had viral load results returned, 101 had detectable viral loads (median viral load: 451 UI/mL), and 12 were linked to care. Of the 507 individuals who screened positive for anti-HCV, 468 had their viral load results returned (median viral load: 1,130,000 UI/mL), 304 had detectable viral loads, and 230 were linked to care. CONCLUSION Anti-HCV prevalence among Rwandan patients with NCD was high, likely due to their older age. NCD-HCV co-infected patients had high HCV viral loads and may be at risk of poor outcomes from hepatitis C. Hepatitis C micro-elimination campaigns among NCD patients are a feasible and acceptable strategy to enhance case detection in this high-prevalence population with elevated viral loads and may support linkage to care for hepatitis C among elderly populations.
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Affiliation(s)
- Tumusime Musafiri
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
- Department of Public Health, Mount Kenya University, Kigali, Rwanda.
| | | | | | | | | | | | | | | | - Raymond Sekagarura
- Ministry of Health, Butaro District Hospital Cancer Center of Excellence, Burera, Rwanda
| | - Jean Damascene Makuza
- Rwanda Biomedical Centre, HIV, STIs, Viral Hepatitis and OVDC Division, Kigali, Rwanda
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Nadine Karema
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda
| | - Janvier Serumondo
- Rwanda Biomedical Centre, HIV, STIs, Viral Hepatitis and OVDC Division, Kigali, Rwanda
| | - Theoneste Ntakirutimana
- Department of Public Health, Mount Kenya University, Kigali, Rwanda
- School of Public Health, College of Medecine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Dale A Barnhart
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Laterite Data, Research, and Analytics, Nairobi, Kenya
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Olaoye T, Osie-Efietie B, Ogunsanmi OO, Mustapha AM, Asekun-Olarinmoye I, Atulomah NO. Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria. BMC Public Health 2024; 24:591. [PMID: 38395844 PMCID: PMC10893707 DOI: 10.1186/s12889-024-18092-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria. METHODOLOGY A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen's D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance. RESULTS At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents.
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Affiliation(s)
- Titilayo Olaoye
- Department of Public Health, Babcock University, Ilishan Remo-Ogun State, Ilishan, Nigeria
| | | | - Ololade O Ogunsanmi
- Department of Public Health, Babcock University, Ilishan Remo-Ogun State, Ilishan, Nigeria
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Arrivillaga MR, Gold M, Rivera EP, Juárez JG. Incorporating an intersectional gender approach to improve access to maternal and child health screening services. Int J Equity Health 2024; 23:32. [PMID: 38378594 PMCID: PMC10880357 DOI: 10.1186/s12939-024-02109-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND In the Americas, the Pan American Health Organization (PAHO) has promoted initiatives that aim at the elimination of mother-to-child transmitted diseases for over two decades. Although Guatemala has assumed the commitment to improve access and coverage of reproductive and perinatal services, the goals have not yet been reached. Often, the implementation of these efforts is hampered by complexities rooted in social, cultural, and environmental intersections. The objective of this work is to share our experience applying gender intersectionality as a methodological and analytical tool in a participatory research project that aims to improve access to maternal and child health screening services. The study shows the novel strategy that incorporates intersectionality contributing to evidence on how it can be applied to strengthen public health efforts around the implementation of the EMTCT Plus (Elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas disease) framework, in the mostly rural municipality of Comapa, in Guatemala. METHODS We applied a participatory methodology, integrating theoretical and methodological frameworks to have an intersectional understanding of health services delivered by both, midwives, and the public health institution, for the prevention, diagnosis, treatment, and follow-up of HIV, Syphilis, Hepatitis B, and Chagas. The data was collected by conducting interviews, focus groups, workshops, and reviewing laboratory databases, guided by five strategies from a cultural appropriateness framework. RESULTS The intersectional analysis shed light on the synergies and gaps of the current efforts and protocols implemented by both the midwives and the Ministry of Health. The services offered for the four diseases were often delivered independently from each other, and a comprehensive educational and communication material strategy was absent. However, our findings will be used to inform consistent, locally relevant, and culturally appropriate educational content for the local population, also following the national policy guidelines. CONCLUSIONS Using intersectionality as a method and as an analytical tool allowed us to understand the (1) interrelation of diverse social, cultural, and environmental determinants which influence the delivery of health services, as well as (2) the dynamics between the traditional and institutional health systems. (3) Community engagement and the participation of different stakeholders in a consultative process have been fundamental for the conceptual and methodological tenets of this research. (4) Finally, giving a more prominent role to midwives can strengthen sustainability and cultural appropriateness, which is complementary to the delivery of institutional health services.
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Affiliation(s)
- Margarita Rivera Arrivillaga
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95 Zona 15 VH III, Guatemala City, Guatemala.
| | - Marina Gold
- Fundación Mundo Sano, Recaredo, 3. Puerta Garaje, 28002, Madrid, Spain.
| | - Elizabeth Pellecer Rivera
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95 Zona 15 VH III, Guatemala City, Guatemala
- Environmental Sciences, University of Maine, Orono, ME, 04469-5755, USA
| | - Jose Guillermo Juárez
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Av. 11-95 Zona 15 VH III, Guatemala City, Guatemala
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Bai S, Dang W, Hong W, Liao W, Smith RD. The prevalence of hepatitis B in Chinese general population from 2018 to 2022: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:211. [PMID: 38365596 PMCID: PMC10870619 DOI: 10.1186/s12879-024-09103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Within China, Hepatitis B virus (HBV) infection remains widely prevalent and one of the major public health problems. There have been only two previous estimates of its prevalence at the population level in China, with the latest survey conducted in 2006. A meta-analysis estimated the prevalence of HBV within China between 2013 and 2017 as 7%. This review provides an updated estimate of HBV prevalence in China from 2018 to 2022. METHODS Systematic searches of literature from January 1, 2018 to December 25, 2022 were conducted in four international databases (Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews) and three Chinese databases (CNKI, CBM, and WanFang data). Random-effects meta-analyses were conducted to calculate the pooled HBV prevalence with 95% confidence intervals in the overall population and subgroups. Publication bias, heterogeneity between studies, and study quality were assessed. RESULTS Twenty-five articles were included in the meta-analysis. The pooled prevalence of HBV infection in the Chinese general population from 2018 to 2022 was 3% (95%CI: 2-4%). The prevalence of HBV infection was similar between males and females (both 3%), while rural areas had a higher prevalence than urban areas (3% vs 2%). The highest prevalence of HBV was reported in the eastern provinces (4, 95%CI: 2-6%). The HBV prevalence of people aged ≥18 years old (6, 95%CI: 4-8%) was higher than people aged < 18 years old (0, 95%CI: 0-1%). CONCLUSION Compared to the previous meta-analysis prevalence in 2013-2017, the updated meta-analysis estimated prevalence of HBV infection (3%) from 2018 to 2020 showed a decreasing trend, suggesting China had moved into a lower intermediate epidemic area (2-5%). However, the prevalence of HBV in rural areas and eastern regions was still higher than the national average. People aged ≥18 years old showed a higher HBV prevalence. HBV prevention should be prioritized in the highest-prevalence areas and high-risk populations. Due to heterogeneity in data collection methods among studies, there remains a need for systematic surveillance of nationwide HBV prevalence.
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Affiliation(s)
- Shuwen Bai
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wen Dang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wenying Hong
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wenyu Liao
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Robert David Smith
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Ataman E, Harputluoglu M, Carr BI, Gozukara H, Ince V, Yilmaz S. HBV viral load and tumor and non-tumor factors in patients with HBV-associated HCC. Hepatol Forum 2024; 5:73-76. [PMID: 38487738 PMCID: PMC10936120 DOI: 10.14744/hf.2023.2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/06/2023] [Accepted: 09/21/2023] [Indexed: 03/17/2024]
Abstract
Background and Aim Several tumor and non-tumor factors affect the prognosis of hepatocellular carcinoma (HCC) patients. This study aimed to investigate the effects of hepatitis B virus (HBV) viral load on tumor and non-tumor factors in patients with HBV-associated HCC. Materials and Methods Patients with hepatitis B and HCC who presented to the HCC council at the Faculty of Medicine, Marmara University Liver Transplantation Institute, were included in our study. Patients were divided into two groups according to the presence or absence of HBV-DNA, and it was determined whether there were differences between these two groups with respect to tumor and non-tumor parameters. Results Comparison of serum alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), hepatitis B surface antigen (HBsAg), and C-reactive protein (CRP) levels between HBV-DNA negative and positive patients showed significant differences (respectively p<0.01, p<0.01, p<0.05, and p<0.05). A major finding was a very significant difference between the two patient groups in terms of portal vein invasion (PVI) and venous invasion (p<0.001 and p<0.01, respectively). However, there was no significant difference in metastasis or lymph node involvement between HBV-DNA negative and positive patients. Conclusion Our findings suggest that HBV viral load plays an important role in PVI in HCC patients, and there is a significant relationship between HBV viral load and inflammation.
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Affiliation(s)
- Engin Ataman
- Department of Gastroenterology and Hepatology, Inonu University Medical Faculty Liver Transplant Institute, Malatya, Turkiye
| | - Murat Harputluoglu
- Department of Gastroenterology and Hepatology, Inonu University Medical Faculty Liver Transplant Institute, Malatya, Turkiye
| | - Brian Irving Carr
- Inonu University Medical Faculty Liver Transplant Institute, HCC Translational Research Unit, Malatya, Turkiye
| | - Harika Gozukara
- Department of Biostatistic, Inonu University School of Medicine, Malatya, Turkiye
| | - Volkan Ince
- Department of General Surgery, Inonu University School of Medicine, Liver Transplant Institute, Malatya, Turkiye
| | - Sezai Yilmaz
- Department of General Surgery, Inonu University School of Medicine, Liver Transplant Institute, Malatya, Turkiye
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Alajlan TI, Jahan S. Knowledge, attitudes, and practice about hepatitis B infection among primary health care nurses in Buraidah, Qassim Region, Saudi Arabia. J Family Med Prim Care 2024; 13:524-531. [PMID: 38605751 PMCID: PMC11006064 DOI: 10.4103/jfmpc.jfmpc_615_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 04/13/2024] Open
Abstract
Background Nurses are at increased risk of acquiring HB infection due to occupational exposure. To control this infection, basic knowledge and a positive attitude toward HB prevention are required. This study was conducted to assess knowledge, attitude, and practice of HB infection preventative measures among primary healthcare nurses in Buraidah, Saudi Arabia. Materials and Methods A descriptive cross-sectional survey was conducted from February to March 2018. A self-administered questionnaire was distributed to all nurses working in primary healthcare centers. Data were analyzed with descriptive and inferential statistics. Results Of the 335 eligible participants, 262 (78%) responded to the survey. Overall, 41.2% of participants had a moderate level of knowledge about HB; however, there was no significant difference in knowledge between males and females. The majority (94.7%) had positive attitudes toward HB. Male nurses displayed significantly more positive attitudes than female nurses (P = 0.0075). Most of the respondents practiced good compliance with universal precautions. The majority (85.5%) were vaccinated, of whom 72.3% were completely vaccinated. About 14.1% of nurses were exposed to high-risk HB conditions; of these, 40.5% immediately reported their injuries. Conclusions The majority of participants had moderate knowledge and a positive attitude but still need more information about HB prevention. Improving knowledge, attitudes, and good practices regarding hepatitis B prevention will contribute to increased awareness among nurses, leading to improvement in healthcare services.
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Affiliation(s)
| | - Saulat Jahan
- Family Medicine Academy, Qassim Health Cluster, Buraidah, Saudi Arabia
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Gopalakrishna H, Mironova M, Dahari H, Koh C, Heller T. Advances and Challenges in Managing Hepatitis D Virus: Evolving Strategies. Curr Hepatol Rep 2024; 23:32-44. [PMID: 38533303 PMCID: PMC10965034 DOI: 10.1007/s11901-024-00643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 03/28/2024]
Abstract
Purpose of Review Hepatitis D Virus (HDV), although a small defective virus, poses a substantial public health challenge due to lack of awareness, underrecognized prevalence, and limited treatment options. Universal HDV screening within hepatitis B virus (HBV) cohorts is essential to address this issue. Despite its aggressive nature, effective HDV therapies have remained elusive for over four decades. Recent Findings Advances in understanding HDV's biology and clinical behavior offer potential therapeutic breakthroughs, fostering optimism. As insights grow, effective and targeted therapies are being developed to improve HDV management. Summary This review delves into HDV's intricate structure and biology, highlighting formidable hurdles in antiviral development. It emphasizes the importance of widespread screening, exploring noninvasive diagnostics, and examining current and emerging innovative therapeutic strategies. Moreover, the review explores models for monitoring treatment response. In essence, this review simplifies the complexities of effectively combating HDV.
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Affiliation(s)
- Harish Gopalakrishna
- Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Maria Mironova
- Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Harel Dahari
- The Program for Experimental & Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Christopher Koh
- Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Theo Heller
- Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
- Translational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Building 10, Room 4-5722, Bethesda, MD 20892-1800, USA
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Zingg SCW, Lemon K. Donor Viral Hepatitis and Liver Transplantation. Surg Clin North Am 2024; 104:67-77. [PMID: 37953041 DOI: 10.1016/j.suc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Despite increasing numbers of organ transplants completed each year, there continues to be an organ shortage in liver transplantation. This has led to the utilization of previously discarded or "marginal" allografts, such as those from donors with hepatitis C virus (HCV) or hepatitis B virus (HBV). The advent of direct acting antivirals and nucleos(t)ide analogs has allowed these allografts to be safely transplanted regardless of the recipients' hepatitis status with comparable graft and patient survival. Recent advances have even allowed usage of actively viremic donors with similar graft and patient outcomes. This article presents an overview of the use of HCV positive and HBV positive allografts.
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Affiliation(s)
- Sara-Catherine Whitney Zingg
- Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267, USA. https://twitter.com/transplant_u
| | - Kristina Lemon
- Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267, USA; Division of Transplantation, University of Cincinnati School of Mediicne, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267, USA.
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Lok J, Veloz MFG, Byrne R, Carey I, Childs K, Agarwal K, Nelson M. Switching Tenofovir Disoproxil Fumarate (TDF) to Tenofovir Alafenamide Fumarate (TAF) in Hepatitis B/HIV Co-Infection: A Feasibility Study. Clin Ther 2024; 46:159-163. [PMID: 38143153 DOI: 10.1016/j.clinthera.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/09/2023] [Accepted: 11/26/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE Tenofovir alafenamide (TAF) delivers the active metabolite more efficiently to target cells compared with tenofovir disoproxil fumarate (TDF). Recent studies suggest that TAF is efficacious in treatment naïve individuals who are co-infected with HBV/HIV and may have superior effects on HBV e antigen (HBeAg) seroconversion in this setting. The primary objective of this study was to explore the feasibility of switching from TDF to TAF in HBV/HIV co-infection. METHODS In this single-arm, multicenter, open-label study, we recruited patients (n = 20) who were on stable TDF-based antiviral therapy for at least 12 months. All participants had undetectable HIV RNA and HBV DNA levels at the time of screening and were converted to a TAF-based treatment regimen (TAF + emtricitabine + third agent) for 48 weeks. FINDINGS Twenty-seven individuals were invited to take part in the screening process; 3 met the exclusion criteria and a further 4 withdrew consent prior to enrolment. The remaining participants were predominantly male (70%), non-cirrhotic (95%) and of Afro-Caribbean ethnicity (60%). All were co-infected with HIV-1 and established on long-term antiretroviral treatment prior to enrolment (median 6.5 years). No adverse events related to the study drug were observed, and most patients (89.5%) maintained undetectable HIV RNA and HBV DNA throughout the follow-up period. IMPLICATIONS Switching from TDF to TAF in HBV/HIV co-infection was safe, well tolerated and maintained virological suppression in most patients. Additional studies are needed to confirm these findings in larger cohorts and explore other endpoints.
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Affiliation(s)
- James Lok
- Institute of Liver Studies, King's College Hospital, London, UK.
| | | | - Ruth Byrne
- Department of HIV/GUM, Chelsea and Westminster Hospital, London, UK
| | - Ivana Carey
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Kate Childs
- Department of Sexual Health, King's College Hospital, London, UK
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Mark Nelson
- Department of HIV/GUM, Chelsea and Westminster Hospital, London, UK
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Sun X, Song L, Lin L, Ding A, Wang C, Ma X, Zhou S, Cai J, Tang H. Development of tenofovir monobenzyl ester phosphonoamidate prodrugs with improved anti- hepatitis B virus activity and intrahepatic tenofovir enrichment. Bioorg Med Chem 2024; 99:117607. [PMID: 38246114 DOI: 10.1016/j.bmc.2024.117607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024]
Abstract
Various tenofovir (TFV) prodrugs have been developed by introducing masking groups to the hydroxyls of the monophosphonate group to enhance intestinal absorption efficiency and therapeutic effects. However, the reported TFV prodrugs have drawbacks such as low bioavailability, systemic toxicity caused by their breakdown in non-targeted tissues, and potential low intracellular conversion efficiency. In the present study, we developed a class of TFV monobenzyl ester phosphonoamidate prodrugs without substitutions on the benzene ring. Compared with previous TFV prodrugs, compounds 3a and 3b developed in the present study showed higher anti-hepatitis B virus activity, stronger stability and higher levels of intrahepatic enrichment of the metabolic product (TFV), indicating the potential of these compounds as novel prodrugs with high efficiency and low systemic toxicity for the treatment of hepatitis B.
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Affiliation(s)
- Xizheng Sun
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China; School of Medicine, Nankai University, Tianjin 300071, China
| | - Li Song
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China
| | - Ling Lin
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China
| | - Aizhong Ding
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China
| | - Chunjian Wang
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China
| | - Xiaohui Ma
- Tasly Academy, Tasly Pharmaceutical Group Co., Ltd., Tianjin 300410, China
| | - Shuiping Zhou
- Tasly Academy, Tasly Pharmaceutical Group Co., Ltd., Tianjin 300410, China
| | - Jinyong Cai
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China
| | - Hai Tang
- Jiangsu Tasly Diyi Pharmaceutical Co., Ltd., Huaian 223003, Jiangsu, China.
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Razavi-Shearer D, Child H, Razavi-Shearer K, Voeller A, Razavi H, Buti M, Tacke F, Terrault N, Zeuzem S, Abbas Z, Aghemo A, Akarca U, Al Masri N, Alalwan A, Blomé MA, Jerkeman A, Aleman S, Kamal H, Alghamdi A, Alghamdi M, Alghamdi S, Al-Hamoudi W, Ali E, Aljumah A, Altraif I, Amarsanaa J, Asselah T, Baatarkhuu O, Babameto A, Ben-Ari Z, Berg T, Biondi M, Braga W, Brandão-Mello C, Brown R, Brunetto M, Cabezas J, Cardoso M, Martins A, Chan H, Cheinquer H, Chen CJ, Yang HI, Chen PJ, Chien CH, Chuang WL, Garza LC, Coco B, Coffin C, Coppola N, Cornberg M, Craxi A, Crespo J, Cuko L, De Ledinghen V, Duberg AS, Etzion O, Ferraz M, Ferreira P, Forns X, Foster G, Fung J, Gaeta G, García-Samaniego J, Genov J, Gheorghe L, Gholam P, Gish R, Glenn J, Hamid S, Hercun J, Hsu YC, Hu CC, Huang JF, Idilman R, Jafri W, Janjua N, Jelev D, Jia J, Kåberg M, Kaita K, Kao JH, Khan A, Kim D, Kondili L, Lagging M, Lampertico P, Lázaro P, Lazarus J, Lee MH, Yang HI, Lim YS, Lobato C, Macedo G, Marinho R, Marotta P, Mendes-Correa M, Méndez-Sánchez N, Navas MC, Ning Q, Örmeci N, Orrego M, Osiowy C, Pan C, Pessoa M, Piracha Z, Pop C, Qureshi H, Raimondo G, Ramji A, Ribeiro S, Ríos-Hincapié C, Rodríguez M, Rosenberg W, Roulot D, Ryder S, Saeed U, Safadi R, Shouval D, Sanai F, Sanchez-Avila J, Santantonio T, Sarrazin C, Seto WK, Seto WK, Simonova M, Tanaka J, Tergast T, Tsendsuren O, Valente C, Villalobos-Salcedo J, Waheed Y, Wong G, Wong V, Yip T, Wong V, Wu JC, Yang HI, Yu ML, Yuen MF, Yurdaydin C, Zuckerman E. Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories. J Hepatol 2024; 80:232-242. [PMID: 38030035 DOI: 10.1016/j.jhep.2023.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND & AIMS Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. METHODS We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. RESULTS After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. CONCLUSIONS We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened. IMPACT AND IMPLICATIONS There is a great deal of uncertainty surrounding the prevalence of hepatitis delta virus among people living with hepatitis B virus at the population level. In this study, we aimed to better understand the burden in 25 countries and territories, to refine techniques that can be used in future analyses. We found a lower prevalence in the majority of places studied than had been previously reported. These data can help inform policy makers on the need to screen people living with hepatitis B virus to find those coinfected with hepatitis delta virus and at high risk of progression, while also highlighting the pitfalls that other researchers have often fallen into.
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Pamarthy R, Ali H, Kapuria D. Comparison of inpatient outcomes in patients with Hepatitis B, Hepatitis C, and Hepatitis B and C co-infection with Cirrhosis. Ir J Med Sci 2024; 193:157-163. [PMID: 37261672 DOI: 10.1007/s11845-023-03417-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Hepatitis B (HBV) and Hepatitis C (HCV) are among the most common causes of cirrhosis in the USA, with high mortality and morbidity but comparative outcomes were not well studied. METHODS We retrospectively analyzed cirrhosis patients with HBV, HCV, and HBV/HCV coinfection from 2016 to 2019 in National Inpatient Sample (NIS) database. Our primary outcome was the length of stay (LOS), mean hospital charge and mortality. RESULTS Our study included 701464 cirrhosis patients with HCV (89.7%), HBV (6.8%), and coinfection (3.5%) (P < 0.001). Male gender and white race were more common in all three cohorts (p < 0.001). The mean age for HBV, HCV, and coinfection was 55.59, 58.69, and 58.27 years. The mean LOS for HBV, HCV, and coinfection were 6.59 ± 0.1, 6.02 ± 0.03, and 6.74 ± 0.12 days respectively. The adjusted length of stay was 0.62 days longer in the HBV cohort and 0.61 days longer in the coinfection cohort, compared to the HCV cohort (P < 0.001). Adjusted hospital charges were $15112 higher in the HBV cohort and $ 6312 higher in the coinfection cohort, compared to the HCV cohort (P < 0.001). Patients with HBV had a higher risk of mortality compared to HCV infection (AOR 1.35, [1.22-1.48], P < 0.001); However, patients with coinfection had no difference in mortality compared to HCV infection. CONCLUSION Cirrhosis with HBV and coinfection is associated with increased duration of hospital stay and cost when compared to HCV infection. There is a higher risk of mortality in cirrhotic patients with HBV infection compared to HCV; however, no significant difference in mortality for coinfection compared to HCV.
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Affiliation(s)
- Rahul Pamarthy
- Department of Internal Medicine, East Carolina University, 521 Moye Blvd., 2nd floor, Greenville, NC, 27834, USA.
| | - Hassam Ali
- Department of Internal Medicine, East Carolina University, 521 Moye Blvd., 2nd floor, Greenville, NC, 27834, USA
| | - Devika Kapuria
- Department of Gastroenterology and Hepatology, Washington University, St. Louis, 63110, USA
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Yared G, Sokhn ES, Al-Khatib A, Kassis C, Younes R. Knowledge, Attitude, and Practice of Hepatitis B Vaccination among Dentists in Lebanon. J Contemp Dent Pract 2024; 25:134-140. [PMID: 38514410 DOI: 10.5005/jp-journals-10024-3635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND The hepatitis B virus (HBV) is a serious occupational hazard for healthcare workers, including dentists. The purpose of this study is to assess dentists' knowledge, attitude, and practice (KAP) with respect to hepatitis B vaccination. MATERIALS AND METHODS A cross-sectional survey of a representative sample of dentists (n = 349) from Lebanon was carried out. Participants' knowledge of hepatitis B, attitudes toward vaccination, and immunization habits were assessed using a standardized questionnaire. To examine the data, descriptive statistics were used, and associations between variables were investigated using appropriate statistical tests. RESULTS The study found that most participating dentists are HBV-vaccinated. These dentists boast a basic to a significantly substantial understanding of HBV infection prevention strategies, such as immunization, routine preventive measures, and handling equipment. Notwithstanding the generally positive attitudes towards vaccination, a proportion of dentists lacked some HBV prevention practices, specifically with respect to conducting regular follow-ups of anti-HBs titer levels and getting booster vaccination doses when warranted. CONCLUSION This study sheds light on the KAP of hepatitis B immunization among Lebanese dentists. The findings emphasize the significance of focused educational efforts in view of improving awareness and encouraging a more thorough understanding of the benefits of vaccination. The study provides useful data that can be used to influence public health policies as well as activities aimed at increasing hepatitis B vaccination rates among dental professionals in Lebanon. How to cite this article: Yared G, Sokhn ES, Al-Khatib A, et al. Knowledge, Attitude, and Practice of Hepatitis B Vaccination among Dentists in Lebanon. J Contemp Dent Pract 2024;25(2):134-140.
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Affiliation(s)
- Ghassan Yared
- Department of Oral Medicine and Radiology, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Phone: +961 3605340, e-mail:
| | - Elie S Sokhn
- Department of Laboratory Medicine, Lebanese Hospital Geitaoui - University Medical Center (UMC), Achrafieh; Department of Medical Laboratory Technology, Molecular Testing Laboratory, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Aynaa Al-Khatib
- Department of Medical Laboratory Technology, Molecular Testing Laboratory, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Cynthia Kassis
- Department of Esthetic and Restorative Dentistry, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon
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Dahal K, Rawal L, Shah S, Dahal M, Shrestha G. Knowledge, attitude and practice towards Hepatitis B vaccination among medical undergraduate students of Maharajgunj Medical Campus in Nepal: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:782-788. [PMID: 38333258 PMCID: PMC10849333 DOI: 10.1097/ms9.0000000000001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/15/2023] [Indexed: 02/10/2024] Open
Abstract
Background The rate of Hepatitis B virus (HBV) infection among health professionals is about 2-10 times higher than that of the general population since, they are more prone for exposure to infected blood and body fluid and contaminated needles and syringes. The risk of accidental exposure among the medical students is even higher due to their non-experience, insufficient training and lack of preventive knowledge. The objective of this study is to assess knowledge, attitude, and practice of medical students towards Hepatitis B. Methods A cross-sectional study design was conducted among 206 medical undergraduate students from May 2022 to July 2022. A pretested self- administered questionnaire was used to collect data regarding knowledge, attitude, and practice towards Hepatitis B vaccination. Non-probability convenience sampling was used to collect data. Descriptive analysis was done by calculating frequency and percentages of categorical variables. χ2 test was used to determine the association between categorical independent variables and categorical dependent variables. Results Among 206 students, 93.7% of them had good knowledge and 98.5% had good attitude. The practice was low with only 35% having safe practices. Similarly, only 46.6% of medical students were completely vaccinated. 23.8% had done Hepatitis B testing. Students who had encountered Hepatitis B patients during their posting were 51.9%. There was significant association of sociodemographic variables with knowledge, attitude and practice towards Hepatitis B vaccination. Conclusion Although, the knowledge and attitude towards Hepatitis B vaccination is high, the practice levels are very low. This indicates need for immunizing medical students against Hepatitis B and reforming training curriculum more focusing on preventive practices against HBV.
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Affiliation(s)
| | | | | | | | - Gambhir Shrestha
- Department of Community Medicine, Institute of Medicine, Tribhuvan University, Maharajgunj
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Martyn E, O'Regan S, Harris P, Leonard M, Veitch M, Sultan B, Matthews PC, Ghosh I, Story A, Surey J. Hepatitis B virus (HBV) screening, linkage and retention-in-care in inclusion health populations: Evaluation of an outreach screening programme in London. J Infect 2024; 88:167-172. [PMID: 38159579 PMCID: PMC7615690 DOI: 10.1016/j.jinf.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES We evaluated a hepatitis B virus (HBV) screening programme, delivered by a specialist pan-London multidisciplinary outreach team, to understand population characteristics and care cascade among people who experience extreme social exclusion (Inclusion Health (IH) groups). METHODS Point-of-care HBV screening was performed in temporary accommodation for people experiencing homelessness (PEH) and people seeking asylum (initial accommodation centres, IACs) via a mobile unit staffed by peers with lived experience, nurses, and doctors. We analysed demographics and HBV characteristics of adults screened between May 2020 and January 2022. We ascertained linkage-to-care (LTC), retention-in-care (RIC) and loss-to-follow-up (LTFU). People LTFU were contacted by peers to re-engage in care. RESULTS 2473 people were screened: 809 in IACs, 1664 in other temporary accommodation. Overall hepatitis B surface antigen (HBsAg) prevalence was 1.7% (43/2473), highest in IACs (3.5%, 28/809). LTC within 3 months was 56% (24/43) and RIC, 87% (26/30). LTC was higher when referred to a local IH-specialist hepatitis service, compared to other services (77%, 17/22 vs 33%, 7/21; p = 0.006). LTFU was 30% (13/43), reduced to 21% (9/43) after intervention by peers. CONCLUSION Our findings support outreach screening among IH populations and peer-supported linkage to IH-specialist hepatitis services. We recommend increased HBV testing and HBV-specific IH specialist services.
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Affiliation(s)
- Emily Martyn
- London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK; The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK.
| | - Sive O'Regan
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Philippa Harris
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Mark Leonard
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Martha Veitch
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Binta Sultan
- Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK; Institute of Global Health, University College London, Gower St, London WC1E 6BT, UK
| | - Philippa C Matthews
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK; Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK; Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK; Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Indrajit Ghosh
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK
| | - Alistair Story
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Collaborative Centre for Inclusion Health, University College London, Gower St, London WC1E 6BT, UK
| | - Julian Surey
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Institute of Global Health, University College London, Gower St, London WC1E 6BT, UK; Universidad Autonoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
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Hu JL, Huang AL. Classifying hepatitis B therapies with insights from covalently closed circular DNA dynamics. Virol Sin 2024; 39:9-23. [PMID: 38110037 PMCID: PMC10877440 DOI: 10.1016/j.virs.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
The achievement of a functional cure for chronic hepatitis B (CHB) remains limited to a minority of patients treated with currently approved drugs. The primary objective in developing new anti-HBV drugs is to enhance the functional cure rates for CHB. A critical prerequisite for the functional cure of CHB is a substantial reduction, or even eradication of covalently closed circular DNA (cccDNA). Within this context, the changes in cccDNA levels during treatment become as a pivotal concern. We have previously analyzed the factors influencing cccDNA dynamics and introduced a preliminary classification of hepatitis B treatment strategies based on these dynamics. In this review, we employ a systems thinking perspective to elucidate the fundamental aspects of the HBV replication cycle and to rationalize the classification of treatment strategies according to their impact on the dynamic equilibrium of cccDNA. Building upon this foundation, we categorize current anti-HBV strategies into two distinct groups and advocate for their combined use to significantly reduce cccDNA levels within a well-defined timeframe.
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Affiliation(s)
- Jie-Li Hu
- Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
| | - Ai-Long Huang
- Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
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Mane A, Agarwal R, Bajpai M, Sane S, Vidhate P, Rakshit P, Madan P, Gogia H, Abraham P, Kabra S, Gupta E. Validation of dried blood spot for serological diagnosis of Hepatitis B and C: a multicentric study. Diagn Microbiol Infect Dis 2024; 108:116108. [PMID: 38000329 DOI: 10.1016/j.diagmicrobio.2023.116108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 11/26/2023]
Abstract
The present study aimed to determine diagnostic performance of dried blood spot (DBS) for the detection of Hepatitis B surface antigen (HBsAg) and Hepatitis C virus antibodies (anti-HCV) using CLIA at 3 different laboratories across India. DBS can serve as a simple and convenient alternative to plasma/serum for HBsAg detection. However for anti-HCV, site-specific validation of the assay is warranted.
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Affiliation(s)
- Arati Mane
- Division of Microbiology, ICMR- NARI, Pune, India
| | - Reshu Agarwal
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Meenu Bajpai
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Suvarna Sane
- Division of Epidemiology and Biostatistics, ICMR- NARI, Pune, India
| | - Pallavi Vidhate
- Division of Epidemiology and Biostatistics, ICMR- NARI, Pune, India
| | | | - Preeti Madan
- National Centre for Disease Control, New Delhi, India
| | - Hema Gogia
- National Centre for Disease Control, New Delhi, India
| | - Priya Abraham
- Department of Virology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sandhya Kabra
- National Centre for Disease Control, New Delhi, India
| | - Ekta Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India.
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Fratzl M, Bigotte P, Gorbenkov R, Goubet G, Halfon P, Kauffmann P, Kirk D, Masse V, Payet-Burin X, Ramel O, Delshadi S. Magnetically localized and wash-free fluorescent immuno-assay: From a research platform (MLFIA) to a multiplexed POC system (MagIA). SLAS Technol 2024:S2472-6303(24)00001-3. [PMID: 38302059 DOI: 10.1016/j.slast.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Sexually transmitted infections (STI) remain one of the world's public health priorities: Nearly 400 million people are infected not only in emerging, but also in western countries. HIV, HBV and HCV share common infection pathways; thus these 3 diseases are recommended to be tested at the same time. However, this combined approach is currently mainly available in laboratories, and seldomly at the Point-of-care (POC). Consequently, there is a need for a STI screening POC platform with laboratory-like performance. Such a platform should be autonomous and portable and enable multiplexed screening from capillary blood. The previously developed and introduced MLFIA (Magnetically Localized and wash-free Fluorescent Immuno-Assay) technology has the potential to address these needs, as the MLFIA 18-chamber microfluidic cartridge and the MLFIA Analyzer were previously characterized and evaluated with plasma and serum from patients infected with HIV, Hepatitis B (Hep B) or C (Hep C). Here, we present the efforts to transfer this research platform (MLFIA) to a fully integrated multi-analysis solution (MagIA). First, we present the design changes of the consumable enabling to perform multiple assays in parallel, a fast filling of the cartridge with patient samples, and a homogeneous reagent/sample incubation. Second, we describe the development a piezoelectric actuator integrated into the Analyzer: this mixing module allows for an automated, fully integrated and portable workflow, with homogeneous in-situ mixing capabilities. The obtained MagIA platform was further characterized and validated for immunoassays (LOD, cartridge stability over time), using various biological models including OVA and IgG. We discuss the performances of the MLFIA and MagIA platforms for the detection of HIV / Hep B / Hep C using results from 102 patient plasma samples. Lastly, we assessed the compatibility of the MagIA platform with veinous and capillary blood samples as a final step towards its POC validation.
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Affiliation(s)
- M Fratzl
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Bigotte
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - R Gorbenkov
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - G Goubet
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Halfon
- Hopital Europeen, Laboratoire Alphabio-Biogroup, Marseille 13003, France
| | - P Kauffmann
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - D Kirk
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - V Masse
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - X Payet-Burin
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - O Ramel
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - S Delshadi
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France.
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48
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Begum TF, Patil VS, Zhu L, Yeh MC, González E, Fraser MA, Lu W, Zhu S, Rubio-Torio N, Ma GX, Tan Y. Assessing Physicians' Recommendations for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Testing Among Minority Populations in Greater Philadelphia and New York City. J Community Health 2024:10.1007/s10900-023-01316-3. [PMID: 38286964 DOI: 10.1007/s10900-023-01316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/31/2024]
Abstract
Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians' recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk.
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Affiliation(s)
- Thoin F Begum
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
| | - Vidya S Patil
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, New York, NY, USA
| | - Evelyn González
- Office of Community Outreach, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | | | - Wenyue Lu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Steven Zhu
- Pennsylvania United Chinese Coalition, Philadelphia, PA, USA
| | | | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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49
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Zhang DL, He X, Feng DN, Ren MJ, Guang YH, Li LX, Wang HB, Liu ZW. [17-year study on the curative effect of treatment to prevent the recurrence of hepatitis B in different risk groups after liver transplantation]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:22-28. [PMID: 38320787 DOI: 10.3760/cma.j.cn501113-20231127-00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Objective: To observe the recurrence condition of hepatitis B in different risk groups after liver transplantation in an attempt to provide useful information on whether to discontinue hepatitis B immunoglobulin (HBIG) in the future at an early stage. Methods: The patient population was divided into high, low-risk, and special groups [especially primary hepatocellular carcinoma (HCC)] according to the guidelines for the prevention and treatment of hepatitis B recurrence after liver transplantation. The recurrence condition and risk factors in this population were observed for hepatitis B. Measurement data were analyzed using a t-test and a rank-sum test. Count data were compared using a χ(2) test between groups. Results: This study finally included 532 hepatitis B-related liver transplant cases. A total of 35 cases had HBV recurrence after liver transplantation, including 34 cases that were HBsAg positive, one case that was HBsAg negative, and 10 cases that were hepatitis B virus (HBV) DNA positive. The overall HBV recurrence rate was 6.6%. The recurrence rate of HBV was 9.2% and 4.8% in the high- and low-risk HBV DNA positive and negative groups before surgery (P = 0.057). Among the 293 cases diagnosed with HCC before liver transplantation, 30 had hepatitis B recurrence after surgery, with a recurrence rate of 10.2%. The independent related factors for the recurrence of hepatitis B in patients with HCC after liver transplantation were HCC recurrence (HR =181.92, 95%CI 15.99~2 069.96, P < 0.001), a high postoperative dose of mycophenolate mofetil dispersible tablets (MMF) ( HR =5.190, 95%CI 1.289~20.889, P = 0.020), and a high dosage of HBIG (HR = 1.012, 95%CI 1.001~1.023, P = 0.035). Among the 239 cases who were non-HCC before liver transplantation, five cases (recurrence rate of 2.1%) arouse postoperative hepatitis B recurrence. Lamivudine was used in all cases, combined with on-demand HBIG prophylaxis after surgery. There was no hepatitis B recurrence in non-HCC patients who treated with entecavir combined with HBIG after surgery. Conclusion: High-barrier-to-resistance nucleotide analogues combined with long-term HBIG have a good effect on preventing the recurrence of hepatitis B after liver transplantation. The discontinuation of HBIG may be considered at an early stage after administration of a high-barrier-to-resistance nucleotide analogue in low-risk patients. Domestically, the HBV infection rate is high, so further research is still required to explore the timing of HBIG discontinuation for high-risk patients, especially those with HCC.
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Affiliation(s)
- D L Zhang
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - X He
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - D N Feng
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - M J Ren
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - Y H Guang
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - L X Li
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - H B Wang
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - Z W Liu
- Liver Disease Department, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
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50
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Torane VP, Patil P, Wanjare S, Nataraj G. Prevalence of HIV, syphilis, hepatitis B, and hepatitis C in patients attending STI/RTI clinic of a tertiary care teaching hospital. J Natl Med Assoc 2024:S0027-9684(24)00002-6. [PMID: 38245467 DOI: 10.1016/j.jnma.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Patients attending Sexually transmitted infection/ Reproductive tract infection (STI/RTI) clinics are investigated for HIV and syphilis under the National AIDS Control Program (NACP). Although sexual contact is one of the modes of transmission of hepatitis B and C, they are not investigated under NACP. This study was planned to find the prevalence of HIV, syphilis, hepatitis B, and C in patients attending STI/RTI clinics and to identify the predictive risk factors. METHODS A prospective cross-sectional study was carried out over 5 years on 500 consenting adults. 10 ml blood was collected and tests were performed as per standard protocol for HIV, syphilis, hepatitis B, and C. Risk factors for the sexually transmitted diseases were queried. RESULTS 500 samples were tested, 117(23.4%) men and 383 (76.6%) women. 26(22.2%), 20(17.1%), 11(9.4%) and 01(0.9%) men and 8(2.1%), 36(9.4%), 01(0.3%) and 0(0%) women were positive for HIV, RPR, hepatitis B and C respectively. Dual infection for HIV and syphilis was detected in four (0.8%) men and HIV and hepatitis B in three (0.6%) men. CONCLUSION To investigate all patients attending STI/RTI clinics for Hepatitis B and to integrate Hepatitis B testing into the National AIDS Control Program.
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Affiliation(s)
- Vijaya P Torane
- Microbiology, Seth Gordhandas Sunderdas Medical College (GSMC) & King Edward Memorial Hospital (KEMH), Mumbai, Maharashtra, India.
| | - Pooja Patil
- Microbiology, Seth Gordhandas Sunderdas Medical College (GSMC) & King Edward Memorial Hospital (KEMH), Mumbai, Maharashtra, India
| | - Shashir Wanjare
- Microbiology, Seth Gordhandas Sunderdas Medical College (GSMC) & King Edward Memorial Hospital (KEMH), Mumbai, Maharashtra, India
| | - Gita Nataraj
- Microbiology, Seth Gordhandas Sunderdas Medical College (GSMC) & King Edward Memorial Hospital (KEMH), Mumbai, Maharashtra, India
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